Risk of testicular cancer in men with abnormal semen characteristics: cohort study
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Testicular cancer and infertility
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Men who have infertility problems have an increased risk of developing testicular cancer, finds a study in this week's BMJ. Sperm quality has possibly been falling over the past few decades while the rates of testicular cancer have been rising, and it is thought that the two could be linked.
Jacobsen and colleagues analysed the sperm quality of semen samples taken from over 32,000 men in Copenhagen between 1963 and 1995. Sperm count, motility, and shape were assessed. Cancer rates were studied and compared with those expected for the whole population of Denmark to determine levels of risk.
There was a strong association between men with infertility problems and the subsequent risk of testicular cancer. Men in couples with fertility problems were over 1.5 times as likely to develop testicular cancer as other men. The risk remained constant over time, suggesting that sperm abnormalities had been present many years before the diagnosis of cancer, say the authors.
Although no one feature was specifically linked to increased risk of testicular cancer, men with poor semen quality overall were between twice and three times as likely to develop testicular cancer. Men with low sperm counts who had fathered children in the past had a lower risk of developing testicular cancer than men who had been unable to father children at all. Poor sperm quality was also associated with an increased risk of cancers of the abdominal cavity (peritoneum) and digestive organs.
The authors conclude that there may be common risk factors for poor sperm quality and testicular cancer, and suggest that these factors may be present in the developing male fetus.
Contact:
Rune Jacobsen, Department of Epidemiology, Institute of Public Health, University of Copenhagen, Denmark
Tel: 45-3-532-7530
Fax: 45-3-535-1181
Email: R.jacobsen@pubhealth.ku.dk