Infertile men 'at greater cancer risk'

Sperm abnormality may be linked to testicular cancer

Infertile men run a slightly increased risk of being diagnosed with testicular cancer, according to a study of more than 32,000 Danish men.

It is the second major study in less than four months to make the link between abnormalities in sperm production and cancer of the testicles.

But the researchers maintain their findings should provide "some reassurance to men identified with abnormal semen characteristics" for the absolute increase in individual risk is small.

The study compared results of semen analysis conducted at a Copenhagen laboratory between 1963 and 1995 with the incidence of testicular cancer in the Danish national cancer register.

'Sperm quality has decreased'

It found 89 cases of testicular cancer among infertile men - a 60% higher rate than in those men without fertility problems.

The researchers point out "the incidence of testicular cancer has increased in the past 50 years and some evidence suggests that sperm quality has decreased in the same period."

The results supporting the findings of a smaller study from the University of Buffalo in the US in June, which also found men who fathered fewer children ran an increased risk of being diagnosed with testicular cancer.

The Danish study established a link between various types of infertility, including low semen concentration and poor sperm motility, and testicular malignancies.

The highest risk of testicular cancer was in the first two years after the first semen analysis.

Link to undescended testicles

An editorial accompanying the study, published in the British Medical Journal, points out that both testicular cancer and infertility is more frequent in men who had undescended testes as children.

There is speculation the problems originate in cell differentiation, in very early life, possibly in the foetus.

The Danish studies also found infertile men have a slightly increased risk of cancer of the peritoneum and other digestive organs.

We need men to be more vigilant and to see their doctors if they suspect there is something wrong but we don't want them to become obsessed with worry

Dr Ian Banks

Chair of the Men's Health Forum, Dr Ian Banks urged men to have "a sense of balance" between taking care of their health and over-worrying about their risk of developing cancer.

In the UK testicular cancer is relatively rare with approximately 1,600 new cases diagnosed each year, he pointed out, and with treatment the prognosis is very good.

"We need men to be more vigilant and to see their doctors if they suspect there is something wrong but we don't want them to become obsessed with worry. Men should examine themselves regularly but not get alarmed about getting cancer," he added.

Around 90 per cent of men with testicular cancer survive at least five years and new treatments are offering hope for those who suffer a recurrence.

An Indiana study published in the American Journal of Clinical Oncology found high dose chemotherapy followed by stem cell transplantation significantly improved outcomes in those men in whom the cancer had recurred.