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Fertility Problems Linked to Testicular Cancer Risk

Men with fertility problems may be at increased risk for testicular cancer, according to results of a large study of Danish men. While previous studies in Denmark have suggested there is a link between infertility and testicular cancer, those studies measured a man's fertility by the number of children he had.

The new study looked at sperm quality and showed that men with abnormalities were two to three times more likely than other men to develop testicular cancer, researchers report in the September 30th issue of the British Medical Journal. The incidence of testicular cancer has risen in Europe and the US in recent decades, and some evidence suggests semen quality has declined over the same time period. Dr. Rune Jacobsen of the Danish National Research Foundation in Copenhagen and colleagues looked at sperm count, as well as the shape and movement of sperm, among more than 32,400 men who had semen samples taken between 1963 and 1995. Each man was part of a couple with fertility problems. Overall, the men had a higher-than-average risk for testicular cancer. Among men with sperm abnormalities, the cancer risk was two to three times higher than average. Poor sperm quality and testicular cancer may share an underlying cause, the authors suggest.

Because testicular cancer strikes young men, experts have speculated that the risk of the disease begins early in life or even in the womb. For example, exposure to maternal hormones during pregnancy may trigger cell malformations that later show up in men as fertility problems and testicular cancer.

Despite this possible new risk factor for testicular cancer, it is important for men to keep the risk in perspective, according to Jacobsen's team. Only 89 of the more than 32,000 men developed testicular cancer, making a man's risk for the disease "very small," the researchers note.

SOURCE: British Medical Journal 2000;321:789-792