The link between male infertility and prostate cancer
A new study was released this week from the journal Cancer that demonstrated a link between male infertility and the development of high-grade prostate cancer. ("Increased risk of high-grade prostate cancer among infertile men". TJ Walsh, M Schembri, PJ Turek, JM Chan, PR Carroll et al. Cancer. 2010 April (ahead of print)).
Details of the male infertility/prostate link study
Doctors Turek and Carroll from the University of California, San Francisco examined a large group of men—more than 22,000—who had been evaluated for infertility from 1967 to 1998. They looked at the incidence of prostate cancer in this group as compared to men from the general population. They found that there was a significant risk among men with male factor infertility to develop high-grade prostate cancer; in fact. men with male factor infertility were found to be 2.6 times more likely to be diagnosed with prostate cancer.
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Male infertility as a risk factor
These results suggest that male factor infertility may be a risk factor for the subsequent development of clinically significant prostate cancer. This study does NOT mean that all men who have suffered from infertility will develop prostate cancer. There are some biases to this study (men who are seeking infertility evaluation may have a higher likelihood of being diagnosed, socioeconomic status, etc.) but these results are consistent with other studies that suggest that there is a decrease in prostate cancer risk in men who have fathered more children. This study should raise our suspicions and concern, and most importantly stimulate additional research to look at this potential link.
Aggressive, early prostate cancer screening
These results, if confirmed, would support aggressive early screening for prostate cancer in men who are identified with male factor infertility. Typically, we start screening for prostate cancer at age 50, unless specific risk factors exist like a family history, when we recommend obtaining a baseline screening at age 40.
Perhaps male factor infertility will become a risk factor, and screening guidelines will reflect this concern, especially given the association with high-grade disease. Risk factors for prostate cancer include age, ethnicity and family history. Prostate cancer occurs most commonly in older men, and occurs more often in African-American men than in men of other races. African -American men are also more likely to be diagnosed at an advanced stage and are more than twice as likely to die of prostate cancer as white men.
Family history of prostate cancer is a risk factor
A family history of prostate cancer is also a significant risk factor. Prostate cancer screening is simple and includes a blood test for Prostate Specific Antigen (PSA) and a digital rectal examination (DRE). It is recommended that men obtain a baseline at age 40, again at 45, and then yearly at age 50. If a significant risk factor exists, then screening can begin at 40 years of age.
Karen Elizabeth Boyle, M.D.
Reproductive Medicine & Surgery, Sexuality and Aesthetics
Contact Us
Karen E. Boyle, M.D.
Phone: 877-290-5055
Fax: 410-825-5811
Chesapeake Urology Associates at Greater Baltimore Medical Center (GBMC)
Physicians Pavilion North
6535 North Charles Street, Suite 625
Baltimore, MD 21204
