Table 3.
The unadjusted relative risk of clinical infertility by demographic, disease and treatment characteristics in survivors of childhood cancer.
| Variable | Na | Unknown n (%)b |
No n (%)b |
Yes n (%)b |
RR (95% CI)c | P |
|---|---|---|---|---|---|---|
| Age at diagnosis | ||||||
| 0–4 | 633 | 32 (5.1%) | 542 (85.6%) | 59 (9.3%) | 0.55 (0.42–0.73) | <0.0001 |
| 5–9 | 771 | 34 (4.4%) | 658 (85.3%) | 79 (10.3%) | 0.60 (0.47–0.78) | 0.0001 |
| 10–14 | 1123 | 46 (4.1%) | 918 (81.8%) | 159 (14.2%) | 0.83 (0.68–1.02) | 0.078 |
| ≥15– <21 | 890 | 62 (7.0%) | 681 (76.5%) | 147 (16.5%) | Referent | |
| Unknown | 114 | 4 (3.5%) | 99 (86.8%) | 11 (9.7%) | ||
| Age at baseline questionnaire | ||||||
| <20 | 227 | 39 (17.2%) | 176 (77.5%) | 12 (5.3%) | 0.54 (0.30–0.95) | 0.033 |
| 20–24 | 749 | 16 (2.1%) | 695 (92.8%) | 38 (5.1%) | 0.44 (0.31–0.62) | <0.0001 |
| >24–29 | 1040 | 30 (2.9%) | 890 (85.6%) | 120 (11.5%) | Referent | |
| >29–34 | 916 | 41 (4.5%) | 716 (78.2%) | 159 (17.4%) | 1.53 (1.23–1.90) | 0.0001 |
| >34–39 | 542 | 47 (8.7%) | 383 (70.7%) | 112 (20.7%) | 1.90 (1.51–2.41) | <0.0001 |
| >39– <40 | 57 | 5 (8.8%) | 38 (66.7%) | 14 (24.6%) | 2.27 (1.40–3.66) | 0.0008 |
| Unknown | 0 | |||||
| Education | ||||||
| Not HS graduate | 278 | 33 (11.9%) | 205 (73.7%) | 40 (14.4%) | Referent | |
| Completed HS | 645 | 44 (6.8%) | 509 (78.9%) | 92 (14.3%) | 0.94 (0.67–1.32) | 0.71 |
| Post HS, some college | 1287 | 89 (6.9%) | 1036 (80.5%) | 162 (12.6%) | 0.83 (0.60–1.14) | 0.24 |
| College graduate | 1107 | 5 (0.5%) | 980 (88.5%) | 122 (11.0%) | 0.68 (0.49–0.94) | 0.021 |
| Unknown | 214 | 7 (3.3%) | 168 (78.5%) | 39 (18.2%) | ||
| Race | ||||||
| White non-Hispanic | 2952 | 155 (5.3%) | 2419 (81.9%) | 378 (12.8%) | Referent | |
| Hispanic | 80 | 2 (2.5%) | 69 (86.3%) | 9 (11.3%) | 0.85 (0.46–1.59) | 0.62 |
| Black | 172 | 11 (6.4%) | 137 (79.7%) | 24 (14.0%) | 1.10 (0.75–1.61) | 0.61 |
| Other | 315 | 10 (3.2%) | 264 (83.8%) | 41 (13.0%) | 0.99 (0.74–1.34) | 0.97 |
| Unknown | 12 | 0 (0.0%) | 9 (75.0%) | 3 (25.0%) | ||
| Marital status | ||||||
| Married/Living as married | 1908 | 28 (1.5%) | 1514 (79.4%) | 366 (19.2%) | 8.70 (5.75–13.17) | <0.0001 |
| Widowed, Divorced, Separated | 354 | 9 (2.5%) | 295 (83.3%) | 50 (14.1%) | 6.48 (4.01–10.45) | <0.0001 |
| Never married | 1103 | 75 (6.8%) | 1005 (91.1%) | 23 (2.1%) | Referent | |
| Unknown | 166 | 66 (39.8%) | 84 (50.6%) | 16 (9.6%) | ||
| Smoking status | ||||||
| Current smoker | 688 | 13 (1.9%) | 566 (82.3%) | 109 (15.8%) | 1.27 (1.04–1.56) | 0.020 |
| Former smoker | 465 | 6 (1.3%) | 393 (84.5%) | 66 (14.2%) | 1.13 (0.88–1.45) | 0.32 |
| Never smoked | 2321 | 122 (5.3%) | 1920 (82.7%) | 279 (12.0%) | Referent | |
| Unknown | 57 | 37 (64.9%) | 19 (33.3%) | 1 (1.8%) | ||
| BMI | ||||||
| <18.5 | 332 | 46 (13.9%) | 262 (78.9%) | 24 (7.2%) | 0.72 (0.48–1.08) | 0.11 |
| 18.5 – <25 | 2054 | 97 (4.7%) | 1730 (84.2%) | 227 (11.1%) | Referent | |
| 25.0 – <30 | 660 | 17 (2.6%) | 546 (82.7%) | 97 (14.7%) | 1.30 (1.04–1.62) | 0.020 |
| ≥30 | 410 | 11 (2.7%) | 301 (73.4%) | 98 (23.9%) | 2.12 (1.71–2.62) | <0.0001 |
| Unknown | 75 | 7 (9.3%) | 59 (78.7%) | 9 (12.0%) | ||
| Primary diagnosis | ||||||
| Leukemia | 1006 | 46 (4.6%) | 850 (84.5%) | 110 (10.9%) | Referent | |
| Hodgkin lymphoma or NHL | 927 | 44 (4.8%) | 709 (76.5%) | 174 (18.8%) | 1.72 (1.38–2.14) | <0.0001 |
| CNS | 323 | 17 (5.3%) | 270 (83.6%) | 36 (11.2%) | 1.03 (0.72–1.46) | 0.88 |
| Solid tumor | 1275 | 71 (5.6%) | 1069 (83.8%) | 135 (10.6%) | 0.98 (0.77–1.24) | 0.86 |
| Radiation | ||||||
| Any RT | ||||||
| No | 962 | 43 (4.5%) | 828 (86.1%) | 91 (9.5%) | Referent | |
| Yes | 2194 | 110 (5.0%) | 1774 (80.9%) | 310 (14.1%) | 1.50 (1.21–1.87) | 0.0003 |
| Unknown | 375 | 25 (6.7%) | 296 (78.9%) | 54 (14.4%) | ||
| Abdomen RT | ||||||
| No | 2225 | 97 (4.4%) | 1871 (84.1%) | 257 (11.6%) | Referent | |
| Yes | 853 | 50 (5.9%) | 670 (78.6%) | 133 (15.6%) | 1.37 (1.13–1.66) | 0.0013 |
| Unknown | 453 | 31 (6.8%) | 357 (78.8%) | 65 (14.4%) | ||
| Brain or head RT | ||||||
| No | 2156 | 104 (4.8%) | 1771 (82.1%) | 281 (13.0%) | Referent | |
| Yes | 924 | 43 (4.7%) | 772 (83.6%) | 109 (11.8%) | 0.90 (0.73–1.11) | 0.34 |
| Unknown | 451 | 31 (6.9%) | 355 (78.7%) | 65 (14.1%) | ||
| Pelvis RT | ||||||
| No | 2494 | 108 (4.3%) | 2104 (84.4%) | 282 (11.3%) | Referent | |
| Yes | 583 | 39 (6.7%) | 437 (75.0%) | 107 (18.4%) | 1.66 (1.36–2.04) | <0.0001 |
| Unknown | 454 | 31 (6.8%) | 357 (78.6%) | 66 (14.5%) | ||
| TBI | ||||||
| No | 3041 | 145 (4.8%) | 2517 (82.8%) | 379 (12.5%) | Referent | |
| Yes | 36 | 2 (5.6%) | 24 (66.7%) | 10 (27.8%) | 2.25 (1.32–3.81) | 0.0027 |
| Unknown | 454 | 31 (6.8%) | 357 (78.6%) | 66 (14.5%) | ||
| Radiation dose (Gy) | ||||||
| Uterine | ||||||
| No RT | 962 | 43 (4.5%) | 828 (86.1%) | 91 (9.5%) | Referent | |
| 1–5 | 1799 | 79 (4.4%) | 1494 (83.1%) | 226 (12.6%) | 1.33 (1.05–1.67) | 0.016 |
| 5.1–10 | 81 | 5 (6.2%) | 55 (67.9%) | 21 (25.9%) | 2.79 (1.85–4.22) | <0.0001 |
| 10.1–20 | 86 | 5(5.8%) | 63 (73.3%) | 18 (20.9%) | 2.24 (1.43–3.53) | 0.0005 |
| >20 | 120 | 11 (9.2%) | 82 (68.3%) | 27 (22.5%) | 2.50 (1.71–3.66) | <0.0001 |
| Unknown | 483 | 35 (7.3%) | 376 (77.9%) | 72 (14.9%) | ||
| Pituitary | ||||||
| No RT | 964 | 43 (4.5%) | 830 (86.1%) | 91 (9.4%) | Referent | |
| 1–20 | 1482 | 75 (5.1%) | 1194 (80.6%) | 213 (14.4%) | 1.53 (1.22–1.93) | 0.0003 |
| 20.1–30 | 430 | 8 (1.9%) | 357 (83.0%) | 65 (15.1%) | 1.56 (1.16–2.10) | 0.0034 |
| >30 | 171 | 15 (8.8%) | 140 (81.9%) | 16 (9.4%) | 1.04 (0.63–1.72) | 0.88 |
| Unknown | 484 | 37 (7.6%) | 377 (77.9%) | 70 (14.5%) | ||
| Alkylating agent score | ||||||
| 0 | 1510 | 55 (3.6%) | 1276 (84.5%) | 179 (11.9%) | Referent | |
| 1 | 543 | 25 (4.6%) | 460 (84.7%) | 58 (10.7%) | 0.91 (0.69–1.20) | 0.51 |
| 2 | 429 | 17 (4.0%) | 363 (84.6%) | 49 (11.4%) | 0.97 (0.72–1.30) | 0.82 |
| 3 | 318 | 13 (4.1%) | 242 (76.1%) | 63 (19.8%) | 1.68 (1.30–2.18) | <0.0001 |
| Unknown | 731 | 68 (9.3%) | 557 (76.2%) | 106 (14.5%) | ||
| History of BMT | ||||||
| No | 3302 | 163 (4.9%) | 2714 (82.2%) | 425 (12.9%) | Referent | |
| Yes | 83 | 15 (18.1%) | 56 (67.5%) | 12 (14.5%) | 1.30 (0.77–2.19) | 0.32 |
| Unknown | 146 | 0 (0.0%) | 128 (87.7%) | 18 (12.3%) | ||
| History of relapse | ||||||
| No | 3183 | 124 (3.9%) | 2646 (83.1%) | 413 (13.0%) | Referent | |
| Yes | 348 | 54 (15.5%) | 252 (72.4%) | 42 (12.1%) | 1.06 (0.79–1.42) | 0.71 |
| Unknown | 0 | |||||
| History of second malignancy before baseline | ||||||
| No | 3388 | 156 (4.6%) | 2798 (82.6%) | 434 (12.8%) | Referent | |
| Yes | 143 | 22 (15.4%) | 100 (69.9%) | 21 (14.7%) | 1.29 (0.87–1.93) | 0.21 |
| Unknown | 0 |
a
N includes survivors that reported have ever been sexually active.
b
n (%) are out of total N.
c
RR is based on available data.