Re: Thyroid hypofunction in aging testicular cancer survivors by Nome et al.

This article refers to:

Re: Thyroid hypofunction in aging testicular cancer survivors

Response to “letter to the editor” by Fung et al., Nov. 18th 2021¹

We thank Fung et al. for their thoughtful comment to our article.

We have followed-up on their proposal of additional analyses of the hypothyroidism in 148 Testicular Cancer Survivors (TCSs) after surgery only:

The Table above suggests that hypothyroidism may be more frequent in the cohort of TCSs (surgery only) than in the comparison group, though the limited numbers do not allow tests for statistical significance. We have added 95% confidence intervals to our estimates to further illustrate the limited precision in our sample. However, our findings are not against a hypothesis of in utero endocrine disrupting exposure as an etiology for testicular dysgenesis and thyroid dysfunction.

Table: Treated and untreated hypothyroidism in testicular cancer survivors (TCSs) after surgery only versus males in the comparison group with similar age range (The HUNT3 Survey).

Condition	Prevalence of thyroid hypofunction
	TCSs; surgery only N = 148 (aged 40–79 years)	The HUNT3 survey N = 16,402 (aged 40–79 years)
Untreated*	4.1% (N = 6) 95%CI [1.5–8.6]	3.1% (N = 511) 95%CI [2.9–3.4]
Treated	4.7% (N = 7) 95%CI [1.9–9.5]	2.0% (N = 325) 95%CI [1.8–2.2]
Thyroid hypofunction	8.8% (N = 13) 95%CI [4.8–15]	5.1% (N = 836) 95%CI [4.8–5.4]

*Elevated serum thyrotropin (s-TSH ≥ 3.5mIU/L) without prescription of levothyroxine. s-TSH level adjusted -15%. 95%CI; 95% confidence interval.