Pd37-04 the Effect of Adolescent Chemotherapy on Risk of Future Testosterone Deficiency in Young Adults—a Claims Database Analysis

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD37)1 May 2024PD37-04 THE EFFECT OF ADOLESCENT CHEMOTHERAPY ON RISK OF FUTURE TESTOSTERONE DEFICIENCY IN YOUNG ADULTS—A CLAIMS DATABASE ANALYSIS Courtney A. Stewart, Steven Banner, Pranjal Agrawal, Mark Alshak, Corey Able, Aurora Grutman, Andrew Gabrielson, Nora Haney, and Taylor Kohn Courtney A. StewartCourtney A. Stewart , Steven BannerSteven Banner , Pranjal AgrawalPranjal Agrawal , Mark AlshakMark Alshak , Corey AbleCorey Able , Aurora GrutmanAurora Grutman , Andrew GabrielsonAndrew Gabrielson , Nora HaneyNora Haney , and Taylor KohnTaylor Kohn View All Author Informationhttps://doi.org/10.1097/01.JU.0001009464.98066.03.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Male adolescents with cancer requiring chemotherapy have been shown to be at risk of future infertility due to the negative impact of chemotherapy on spermatogenesis, however, the risk of future testosterone deficiency has not been as well-established as studies have been limited by small sample sizes.Our objective was to assess the association of adolescent chemotherapy with testosterone deficiency and erectile dysfunction (ED) using a large national claims database. METHODS: Searching the TriNetX Research network from 2010 through July 2023, our study cohort included males age ≤35-years who were diagnosed with a neoplasm and treated with chemotherapy at or before the age 18 years. Patients receiving chemotherapy after the age of 18-years or with a history of testicular cancer were excluded. Our control cohort included males age ≤35-years with no history of neoplasm or chemotherapy. Both cohorts excluded men with mortality, Klinefelter's Disease, undescended testicles, orchiectomy, usage of anabolic steroids, personal history of irradiation, or history of isotretinoin use. Propensity score matching was performed for multiple covariates (Table 1). Study outcomes were risk of developing testosterone deficiency or erectile dysfunction. RESULTS: 1,417 men with a history of chemotherapy were compared to propensity-score matched controls. The average age of initiation of chemotherapy was 15.0±2.8 and the average age at follow-up was 24.6±4.1. Overall, 2.4 % of men with a history of adolescent chemotherapy were diagnosed with testosterone deficiency or had a total testosterone value<300. This was significantly higher than in controls (0.75%) (RR 3.2, 95% CI 1.6 – 6.2). When assessing 232 men receiving alkylating chemotherapeutic agents with an equal number of matched controls, rates of testosterone deficiency was 4.3% versus 0.86% in controls (RR 5.0, 95% CI 1.11 – 22.6).Rates of ED diagnosis or new prescriptions for PDE5i were not statistically different between the two cohorts (0.9% in men with a history of adolescent chemotherapy versus 1.5% in those without a history of chemotherapy) (RR 0.59, 95% CI 0.30 – 1.17). CONCLUSIONS: These results demonstrate that men with a history of adolescent chemotherapy were at higher risk of future testosterone deficiency in their early adulthood years. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e800 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Courtney A. Stewart More articles by this author Steven Banner More articles by this author Pranjal Agrawal More articles by this author Mark Alshak More articles by this author Corey Able More articles by this author Aurora Grutman More articles by this author Andrew Gabrielson More articles by this author Nora Haney More articles by this author Taylor Kohn More articles by this author Expand All Advertisement PDF downloadLoading ...