Infertility In Men Poses Risk For Testicular Cancer

By Margarita Nahapetyan

New findings have shown that infertile men are at a triple risk of developing testicular germ cell cancer, compared to the men who do not have this problem.

The new study appears to be the first large research in the United States that confirms the fact that the men with a history of infertility are at a higher risk of testis cancer. Previous studies on this matter were conducted mostly in Europe, and reported significantly higher prevalence of testicular cancer in male population.

To come up with the conclusion, Dr. Thomas J. Walsh, MD, MS, then of the University of California, San Francisco and presently of the University of Washington School of Medicine in Seattle, and his colleagues examined data from 22,562 men who, along with their partners, looked for fertility treatment between 1967 and 1998. More than 4,500 of these men had male factor infertility, that was based on a clinical presentation with abnormal analysis of semen criteria.

After that, the records of these men were linked to the information from the California Cancer Registry in order to identify testicular cancer cases that occurred between the years of 1988 and 2004. The incidence of the disease in the group was compared with the rates in the general population by means of The Surveillance Epidemiology and End Results Program (SEER) of the National Cancer Institute. Men who suffered testicular cancer before infertility were taken out of the study.

The results revealed that 34 of all men in the study have been diagnosed with testicular cancer at least twelve months after seeking cure for infertility. Of these men, 86 per cent developed seminomas, 12 per cent were diagnosed with non-seminomas, and 2 per cent had disease that has not been specified. Patients who were undergoing fertility treatment had 1.3 times greater risk of developing testicular cancer than men that did not use any treatment. After taking into consideration other risk factors it became clear that men who had male factor infertility were almost 3 times more likely to develop the condition compared to healthy men.

According to Walsh, those man who are infertile, have much more chances of developing testicular cancer, and therefore, they should be aware of the risk and be taught by physicians how to evaluate themselves in order to detect the disease. However, he added that the risk is still pretty low in general, and men should not become obsessed by constantly checking themselves and getting overly nervous about the issue.

Based on the new findings, the scientists are not yet sure whether there is the direct relationship between testicular cancer and infertility, but they do not think that it is caused by fertility treatment. They tend to think that either environmental factors or genetics are to blame for. More investigation is still to be done to examine the causes of each and figure out whether there is a definite connection.

Testicular cancer is a comparatively rare form of cancer that strikes 5 out of every 1,000 males in the United States. However, it is the most common malignant disease among younger male generation. Testicular cancers occur much more often in developed rather than in developing countries, suggesting that there are really environmental factors that could be linked to the disease.

The causes of testicular cancer are not well established, but a constantly increasing rates have been connected with early puberty, testicular trauma, cigarette and marijuana smoking, exposure to toxic substances such as lead, or having a family history of testicular cancer. Symptoms of the disease include a lump in the testicle, painful feelings in the groin, enlarged breasts and unexplained weakness.

The details of this study appeared in the February 23, 2008 issue of the Archives of Internal Medicine.