November 21, 2005

Infertility linked to higher testicular cancer risk

By Anne Harding

NEW YORK (Reuters Health) - Men who are undergoing
treatment for infertility are 20 times more likely than men in
the general population to be diagnosed with testicular cancer,
a new study shows. The finding underscores the importance of
urological screening for any man with infertility, Dr. Marc
Goldstein said, especially because this evaluation is often not
a part of infertility treatment.

Male infertility is frequently handled by reproductive
endocrinologists, and "a lot of these men are being funneled
straight to in vitro fertilization," Goldstein of New
York-Presbyterian/Weill Cornell Medical Center told Reuters

There is evidence that infertility and testicular cancer
have a common origin in many cases, beyond the well-known risk
associated with having a history of undescended testes, also
known as cryptorchidism, Goldstein and his team note in the
Journal of Urology.

To investigate the rate of testicular cancer among men with
infertility and abnormal semen, the researchers reviewed charts
from 3,800 men treated over a 10-year period at their center.
Ten cases of testicular cancer were identified.

Using the Surveillance, Epidemiology and End Results
database, infertile men had a 22.6-fold increased risk of
testicular cancer compared with men of similar age in the
general population.

Two of the men had a history of cryptorchidism. When they
were excluded from the analysis, the remaining men still had an
18.3-fold greater risk of the disease.

The findings show that it would be necessary to screen only
500 infertile men to identify one case of testicular cancer,
compared with breast cancer screening of 1,500 women to pick up
a single case.

If a man is infertile, "even if he has enough sperm to
achieve a pregnancy using assisted reproductive techniques, he
should still be seen by a urinologist for an examination and
possibly an ultrasound of the testicle," Goldstein said.

He pointed out that infertility can signal other
life-threatening diseases, such as diabetes, thyroid conditions
or other types of cancer.

SOURCE: Journal of Urology, November 2005.