Azoospermic men more prone to developing cancer

Men who are diagnosed with azoospermia are more prone to developing cancer than the general population, according to a recent study.

While the study wasn’t large enough to delineate which specific types of cancer increased azoospermic men’s incidence rates, the diagnoses covered a wide range of cancers, including prostate and testicular cancer.

A diagnosis of azoospermia before age 30 carries an eightfold cancer risk, say the authors, who published their findings online in Fertility and Sterility (June 24, 2013).

“An azoospermic man’s risk for developing cancer is similar to that for a typical man 10 years older,” said first author Michael Eisenberg, MD, PhD, of Stanford University School of Medicine, Stanford, CA.

The study population consisted of 2,238 infertile men who were seen at an andrology clinic at Baylor College of Medicine, Houston, from 1989 to 2009. Their median age was 35.7 years when they were first evaluated for the cause of their infertility. Of those men, 451 had azoospermia and 1,787 did not. There were otherwise no apparent initial differences between the two groups.

After undergoing a semen analysis, the men were followed for an average of 6.7 years to see which of them turned up in the Texas Cancer Registry. Their rates of diagnosed cancer incidence were then compared with age-adjusted cancer-diagnosis statistics of Texas men in general.

In all, a total of 29 of the 2,238 infertile men developed cancer over a 5.8-year average period from their semen analysis to their cancer diagnosis. This contrasted with an expected 16.7 cases, on an age-adjusted basis, for the male Texas population in general (which, Dr. Eisenberg said, closely reflects cancer incidence rates for the entire U.S. population). This meant that infertile men were 1.7 times as likely to develop cancer as men in the general population. This is considered a moderately increased risk.

But comparing the cancer risk of azoospermic and nonazoospermic infertile men revealed a major disparity: The azoospermic men were at a substantially elevated risk-nearly three times as likely to receive a diagnosis of cancer as men in the overall population. Infertile men who weren’t azoospermic, in contrast, exhibited a statistically insignificant increased cancer risk of only 1.4 times that of men in the overall population.

Cancer diagnoses included those of the brain, prostate, small intestine, and stomach tumors, as well as melanoma, lymphoma, and testicular cancer. The findings suggest that genetic defects that result in azoospermia may also broadly increase a man’s vulnerability to cancer, Dr. Eisenberg said, supporting the notion that azoospermia and cancer vulnerability may share common genetic causes.

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