Objective: To determine whether men with azoospermia are at an elevated risk of developing cancer in the years following an infertility evaluation.
Design: Cohort study.
Setting: United States andrology clinic. Patient(s): A total of 2,238 men with complete records were evaluated for infertility at a single andrology clinic in Texas from 1989 to 2009.
Interventions(s): None.
Main Outcome Measure(s): Cancer incidence was determined by linkage to the Texas Cancer Registry.
Result(s): In all, 451 men had azoospermia, and 1,787 were not azoospermic, with a mean age at infertility evaluation of 35.7 years. Compared with the general population, infertile men had a higher risk of cancer, with 29 cases observed compared with 16.7 expected (standardized incidence rate (SIR) 1.7, 95% confidence interval (CI) 1.2-2.5). When stratifying by azoospermia status, azoospermic men had an elevated risk of cancer (SIR 2.9, 95% CI 1.4-5.4). Infertile men without azoospermia had a trend toward a higher rate of cancer (SIR 1.4, 95% CI 0.9-2.2). The Cox regression model revealed that azoospermic men had 2.2-fold higher cancer risk compared with nonazoospermic men (hazard ratio 2.2, 95% CI 1.0-4.8).
Conclusion(s): Men with azoospermia have an increased risk of subsequently developing cancer, suggesting a possible common etiology between azoospermia and cancer development. Additional follow-up of azoospermic men after reproductive efforts end may be warranted.
Written by:
Eisenberg ML, Betts P, Herder D, Lamb DJ, Lipshultz LI Are you the author?
Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, California.
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Reference: Fertil Steril. 2013 Jun 12. (Epub ahead of print)
doi: 10.1016/j.fertnstert.2013.05.022
PubMed Abstract
PMID: 23790640
