Infertile Men 20 Times More Likely to Have Testicular Cancer

Screen All Your Infertile Male Patients

Men who are infertile and who have an abnormal sperm count are at a 20-fold greater risk of having testicular cancer compared with the general population, according to a new study published in the Journal of Urology?(2005;174: 1819-1822).

A retrospective review of 3847 men presenting with infertility and an ?ab?normal semen analysis over a 10-year period determined that 10 of the men (0.3%) had testicular tumors. Although 2 of these men had a history of ?cryp?torchidism?a risk factor for testicular cancer?the remaining 8 appeared to be at no increased risk. The race- and age-matched control group, taken from the Surveillance, Epidemiology, and End Results database, showed a ?tes?ticular cancer incidence of 106 cases per 100,000 men of similar age and race during the same period. When the incidence of testicular cancer in the infertile men was compared with the controls, the ?stan?dardized incidence ratio was 22.9, ?meaning that infertile men were >20 times more likely to have a testicular tumor.

"Patients and physicians should be aware that one cause of male infertility is cancer, particularly testicular cancer," said investigator Marc Goldstein, MD, surgeon-in-chief of male reproductive medicine and surgery, New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York City. "Screening for testicular ?cancer could now become a standard part of all male infertility treatment." Early diagnosis may in?crease the chances of long-term survival, he added.

The likelihood of finding testicular cancer in infertile men is 1 in 500 patients screened compared, for example, with finding 1 breast cancer among ?1438 women screened with mammography.?

"Examination of all infertile men by a uro?logist is justified," Dr Goldstein said.