Infertile patients at higher risk for testicular cancer

Men with infertility and abnormal sperm counts have a 20-fold greater incidence of testicular cancer than do men in the general population, according to a study published in the Journal of Urology (2005; 174:1819-22). The finding may change clinical practice for male infertility and allow earlier diagnosis of testicular cancer, researchers say.

“Patients and physicians should be aware that one cause of male infertility is cancer, particularly testicular cancer. Screening for testicular cancer could now become a standard part of all male infertility treatment,” said lead author Marc Goldstein, MD, of New York-Presbyterian Hospital/Weill Cornell Medical Center.

A retrospective review of 3,847 men presenting with infertility and abnormal semen analysis during a 10-year period found that 10 men were diagnosed with testicular tumors. Of this group, two men had a history of cryptorchidism, and the other eight men had no identifiable risk factors for testicular cancer. Comparing the incidence of the infertile group to that of the control group, represented by the SEER database, the standardized incidence ratio was 22.9, meaning that infertile men were more than 20 times likely to have a testis tumor.

If the two patients with a history of cryptorchidism were excluded, the incidence ratio would be slightly lower at 18.3.