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Azoospermic men face higher cancer risk
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Infertile, azoospermic men are at a higher risk for cancer, according to study results published in Fertility and Sterility.
Prior genetic-based studies have indicated that male infertility is linked to cancer. Mutations in the Lynch syndrome gene MLH1 have been observed in men with azoospermia, and azoospermic mice deficient in ERCC1 and MSH2have been shown to develop tumors. Other studies linking male infertility to cancer have not isolated azoospermic men to study their risk.
“There is evidence that infertility may be a barometer for men’s overall health, and a few studies have found an association of male infertility with testicular cancer,” Michael Eisenberg, MD, PhD, assistant professor of urology at Stanford University School of Medicine and director of male reproductive medicine and surgery at Stanford Hospital and Clinics, said in a press release.
Michael Eisenberg
Eisenberg and colleagues examined 2,238 infertile men who were seen at the Baylor College of Medicine Special Procedures Laboratory from 1989 to 2009. Of them, 451 were azoospermic (median age, 35.7 years).
Researchers followed the men for a median 6.7 years via the Texas Cancer Registry to check for incidences of cancer. Men who were diagnosed with cancer within 2 to 3 years of being seen at the clinic were excluded from the study because an undiagnosed cancer could have caused the azoospermia.
Overall, 29 of the 2,238 men in the total study population developed cancer, compared with an expected 16.7 cases on an age-adjusted basis for men in the general Texas population, researchers wrote. The finding suggest infertile men were 1.7 times more likely to develop cancer.
Azoospermic men were at an even greater risk (standard incidence ratio[SIR]=2.9; 95% CI, 1.4-5.4), whereas results showed a trend toward a higher rate of cancer in infertile men without azoospermia (SIR=1.4; 95% CI, 0.9-2.2). Cox regression analysis showed azoospermic men had more than twice the risk for cancer than men who were not azoospermic (HR=2.2; 95% CI, 1.0-4.8).
Azoospermic men aged younger than 30 years had the highest risk for cancer (SIR=8.1; 95% CI, 1.0-29.3).
“Further research should focus on the identification of the genetic links between impaired spermatogenesis and cancer, as well as determining if azoospermic men warrant increased cancer screening,” Eisenberg and colleagues wrote.
Disclosure: Eisenberg reports no relevant financial disclosures. See the study for a full list of the researchers’ disclosures.
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