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Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

ABSTRACT: To further understand the association between semen quality and cancer risk by means of well defined semen parameters.Retrospective cohort study.Not applicable.A total of 20,433 men who underwent semen analysis (SA) and a sample of 20,433 fertile control subjects matched by age and birth year.None.Risk of all cancers as well as site-specific results for prostate cancer, testicular cancer, and melanoma.Compared with fertile men, men with SA had an increased risk of testicular cancer (hazard rate [HR] 3.3). When the characterization of infertility was refined using individual semen parameters, we found that oligozoospermic men had an increased risk of cancer compared with fertile control subjects. This association was particularly strong for testicular cancer, with increased risk in men with oligozoospermia based on concentration (HR 11.9) and on sperm count (HR 10.3). Men in the in the lowest quartile of motility (HR 4.1), viability (HR 6.6), morphology (HR 4.2), or total motile count (HR 6.9) had higher risk of testicular cancer compared with fertile men. Men with sperm concentration and count in the 90th percentiles of the distribution (?178 and ?579 × 10(6)/mL, respectively), as well as total motile count, had an increased risk of melanoma (HRs 2.1, 2.7, and 2.0, respectively). We found no differences in cancer risk between azoospermic and fertile men.Men with SA had an increased risk of testicular cancer which varied by semen quality. Unlike earlier work, we did not find an association between azoospermia and increased cancer risk.

SUBMITTER: Hanson HA

PROVIDER: S-EPMC4744156 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

Hanson Heidi A HA Anderson Ross E RE Aston Kenneth I KI Carrell Douglas T DT Smith Ken R KR Hotaling James M JM

Fertility and sterility 20151118 2

<h4>Objective</h4>To further understand the association between semen quality and cancer risk by means of well defined semen parameters.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>Not applicable.<h4>Patient(s)</h4>A total of 20,433 men who underwent semen analysis (SA) and a sample of 20,433 fertile control subjects matched by age and birth year.<h4>Intervention(s)</h4>None.<h4>Main outcome measure(s)</h4>Risk of all cancers as well as site-specific results for prostate cancer, tes ...[more]

PMID: 26604070

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Project description:BackgroundAn association between male subfertility and an increased risk of testicular cancer has been proposed, but conflicting results of research on this topic have rendered this theory equivocal. To more precisely assess the association between subfertility and the risk of testicular cancer, we performed a systematic review of international epidemiologic evidence.Principal findingsWe searched the Medline database for records from January 1966 to March 2008 complemented with manual searches of the literature and then identified studies that met our inclusion criteria. Study design, sample size, exposure to subfertility and risk estimates of testicular cancer incidence were abstracted. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the DerSimonian and Laird model. All statistical tests were two-sided. We identified seven case-control studies and two cohort studies published between 1987 and 2005. Analysis of the seven case-control studies that included 4,954 participants revealed an overall statistically significant association between subfertility and increased risk of testicular cancer (summary RR = 1.68, 95% CI: 1.22 to 2.31), without heterogeneity between studies (Q = 8.46, P heterogeneity = 0.21, I(2) statistics = 0.29). The association between subfertility and testicular cancer was somewhat stronger in the United States (summary RR = 1.75, 95% CI: 1.01 to 3.02) than it was in Europe (summary RR = 1.53, 95% CI: 1.22 to 1.92). The source of the control subjects had a statistically significant effect on the magnitude of the association (population-based summary-RR = 2.15, 95% CI: 1.11 to 4.17; hospital-based summary--RR = 1.56, 95% CI: 0.93 to 2.61). After excluding possible cryptorchidism, an important confounding factor, we also found a positive association between subfertility and increased risk of testicular cancer (summary RR = 1.59, 95% CI: 1.28 to 1.98). These results were consistent between studies conducted in the United States and in Europe (Q = 0.20, P heterogeneity = 0.66). Of the two cohort studies that reported standardized incidence ratios, both reported a statistically significant positive association between subfertility and increased risk of testicular cancer.ConclusionsOur findings support a relationship between subfertility and increased risk of testicular cancer and apply to the management of men with subfertility, and prevention and diagnosis of testicular cancer.

Dataset Information

Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

Publications

Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

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