PURPOSE The aim of this project was to characterize the incidence of men's health disorders, specifically focusing on the incidence of erectile dysfunction (ED) and testosterone deficiency (TD) in a large, nationwide study of testicular cancer (TC) survivors treated in a centralized health care system. PATIENTS AND METHODS We conducted a retrospective cohort study of US veterans diagnosed with TC from 1990 to 2021. These veterans were compared with an age-matched and race-matched control group of US veterans without a diagnosis of TC. ED and TD were defined by the presence of diagnosis codes or at least a 6-month prescription for medications treating these conditions or both. Time was measured from the date of TC diagnosis (for patients with TC and matched TC patient date for the corresponding noncancer controls). Impact of chemotherapy among TC survivors on ED and TD was evaluated using multivariable Cox regression models. RESULTS The cohort included 1754 patients with TC compared with 7117 noncancer controls, with a mean age at diagnosis of 42 years. Patients with TC were significantly more likely than controls to experience ED (HR, 2.97; 95% CI, 2.68-3.28; P < .001) and TD (HR, 6.71; 95% CI, 5.78-7.81; P < .001). However, within the TC group, there was no significant difference in the incidence of ED and TD when stratified by receipt of chemotherapy (P = .9 and P = .066, respectively). CONCLUSIONS Men's health disorders arise commonly in the lives of TC survivors. It is important for treating physicians to identify these and conduct sexual health assessments as part of survivorship care.

中文翻译：

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睾丸癌幸存者勃起功能障碍和睾酮缺乏症的发生率。


目的 该项目的目的是描述男性健康障碍的发生率，特别关注勃起功能障碍 （ED） 和睾酮缺乏症 （TD） 的发生率，这是一项针对在集中医疗保健系统中接受治疗的睾丸癌 （TC） 幸存者的大型全国性研究。患者和方法 我们对 1990 年至 2021 年被诊断患有 TC 的美国退伍军人进行了一项回顾性队列研究。将这些退伍军人与未诊断为 TC 的美国退伍军人的年龄匹配和种族匹配的对照组进行了比较。ED 和 TD 的定义是存在诊断代码或至少 6 个月的治疗这些疾病的药物处方，或两者兼而有之。从 TC 诊断日期开始测量时间（对于 TC 患者和相应的非癌症对照的匹配 TC 患者日期）。使用多变量 Cox 回归模型评估化疗对 TC 幸存者对 ED 和 TD 的影响。结果 该队列包括 1754 名 TC 患者与 7117 名非癌症对照患者，平均诊断年龄为 42 岁。TC 患者发生 ED 的可能性显著高于对照组 （HR，2.97;95% CI，2.68-3.28;P < .001） 和 TD （HR， 6.71;95% CI， 5.78-7.81;P < .001）.然而，在 TC 组中，按接受化疗分层时，ED 和 TD 的发生率没有显著差异 （分别为 P = .9 和 P = .066）。结论 男性健康障碍常见于 TC 幸存者的生活中。治疗医生识别这些并进行性健康评估作为幸存者护理的一部分非常重要。