Infertility linked to high-grade prostate cancer
MedWire News: Results of a US study suggest that infertile men are at higher risk for developing high-grade prostate cancer than fertile men.
Despite this finding, the overall incidence of prostate cancer did not vary between infertile and fertile men, reports the research team.
“These results… suggest that men identified with male factor infertility earlier in life may be considered for prostate cancer screening, given the elevated risk specifically for high-grade disease,” write Thomas Walsh, from University of Washington School of Medicine in Seattle, and colleagues.
Previous research into the etiology of prostate cancer has highlighted a possible association with fatherhood status but has generally relied on number of offspring as a marker for infertility status.
Walsh and team evaluated the association between male infertility and prostate cancer using a multi-institutional cohort of 22,562 men evaluated for infertility in 1960 through 1990. Incidence of prostate cancer observed in the cohort was divided by the number expected for the general population.
A total of 4548 men with male factor infertility were identified, among whom 168 men were diagnosed with prostate cancer. In all, 185 cases were expected. This gave a standard incidence ratio of 0.9 indicating no increased overall risk for the disease among infertile men compared with the general population.
Among the infertile men with prostate cancer, 45 had high-grade (Gleason score 8–10) disease.
After multivariate analysis controlling for age, duration of infertility treatment, and infertility treatment facility, infertile men were 2.6 times more likely to develop high-grade disease compared with men in the general population.
The researchers note that their results may be exposed to possible selection bias since men who seek evaluation for infertility may have a higher likelihood of a cancer diagnosis given their “generally higher socioeconomic status, possibly improved access to healthcare, and their greater propensity to seek medical attention.”
However, they insist, in the journal Cancer, that the findings “warrant further confirmation and should stimulate additional research focusing on possible common biological pathways underlying infertility and prostate cancer.”
Helen Rippon (The Prostate Cancer Charity, UK) said: “This potential new risk factor would need to be backed up by further, large scale studies before any recommendations can be made about targeting early screening for prostate cancer at men with fertility problems.”
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By Sarah Guy