High paternal age may raise PCa rate

The public health impact of increasing paternal age requires further investigation, and clinicians should discuss with their patients the potential impact older fathers may have on their children, according to researchers at Stanford University School of Medicine, Stanford, CA.

They reported that paternal age is on the rise. This is concerning because the prevalence rates of certain cancers, congenital disorders, and psychiatric illnesses have been shown to directly correlate with advancing paternal age.

The authors reported that the mean paternal age in the U.S. increased from 27.4 years in 1972 to 30.9 years in 2015. It is theorized that some cancers, congenital disorders, and other illnesses may be on the rise because of de novo mutations over time as men age.

“There is a significant increase. While we were expecting the number of births with cancer and neurocognitive deficits to increase, we were certainly surprised by the sheer number of births that were estimated to have been affected in 2015 compared to 1972,” said study author Yash Khandwala, MD, urology resident at Stanford. He was a fourth-year medical student at the time of the study’s presentation at the AUA annual meeting in San Francisco.

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Dr. Khandwala said there is a need to further elucidate the role of paternal age on economic burden to society. To date, he said much of the research has been on maternal age and its impact on offspring. He and his colleagues conducted a study to better understand the increase in offspring disease between 1972 and 2015 that may be attributable to increasing paternal age. The team evaluated all births from 1972 to 2015 using weighted data provided by the Centers for Disease Control’s National Vital Statistics System.

“As paternal age is increasing in the U.S., it is imperative that we examine the potential implications. Prior data has suggested that paternal age may affect a child’s health. The current study attempts to quantify the paternal age effect for several diseases,” said senior author Michael L. Eisenberg, MD, director of Male Reproductive Medicine and Surgery and associate professor of urology at Stanford.

For this investigation, the authors categorized births into ranges of paternal age, and all rates were adjusted for maternal age. The number of births affected by each disease was calculated for each year based on the incidence rate of disease for a given paternal age group (cases per 4 million annual births).% of fathers age >40 years more than doubled

The authors found that the percentage of fathers with age greater than 40 years more than doubled over the study period (4.1% to 8.5%). They also found that the increase in paternal age in 2015 may have contributed to an estimated 54,031 additional cases of prostate cancer in their offspring compared to 1972 per 4 million annual births. Achondroplasia due to increasing paternal age was also estimated to increase by 51% (610 cases in 1972 to 923 cases in 2015). The authors estimate there was a 21.6% increase in the incidence of autism and a 39.5% increase in bipolar disease expected in births occurring in 2015 compared to 1972.

The percentage of children born in 2015 expected to suffer from substance abuse increased by 14.2%, and a similar trend was found with failing grades (increase of 13.4%) and low education attainment (2.8%) compared to 1972 due to effects associated with increasing paternal age, according to the authors.

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“Having a sort of rough number of the impact can be helpful,” Dr. Khandwala said in an interview with Urology Times. “Paternal age should be something that is taken into account when planning a pregnancy, and I think it is important to have a discussion with the patient regarding the impact older fathers might have on their children.”

Paul Turek, MD, a men’s reproductive health specialist in San Francisco, said the study findings are somewhat alarming.

“The impact of paternal age on children’s health could conceivably be the first real ‘genetic epidemic’ to hit humanity in the era of genomic medicine,” Dr. Turek told Urology Times.

However, he said that these findings must be viewed with caution.

“Realize that their estimates of diseases and their incidences in offspring is still a murky science, with lots of loose ends and unknowns,” Dr. Turek said.