Department of Urology, University of Washington School of Medicine, Seattle, Washington 98195-6510, USA.
Cancer. 2010 May 1;116(9):2140-7. doi: 10.1002/cncr.25075.
It has been reported that fatherhood status may be a risk factor for prostate cancer. In the current study, the authors examined the subsequent occurrence of prostate cancer in a cohort of men evaluated for infertility to determine whether male infertility is a risk factor for prostate cancer.
A total of 22,562 men who were evaluated for infertility from 1967 to 1998 were identified from 15 California infertility centers and linked to the California Cancer Registry. The incidence of prostate cancer was compared with the incidence in an age-matched and geography-matched sample of men from the general population. The risk of prostate cancer in men with and those without male factor infertility was modeled using a Cox proportional hazards regression model.
A total of 168 cases of prostate cancer that developed after infertility were identified. Men evaluated for infertility but not necessarily with male factors were not found to have an increased risk of cancer compared with the general population (standardized incidence ratio [SIR], 0.9; 95% confidence interval [95% CI], 0.8-1.1). This risk was found to be highest for men with male factor infertility who developed high-grade prostate cancer (SIR, 2.0; 95% CI, 1.2-3.0). On multivariate analyses, men with male factor infertility were found to be 2.6 times more likely to be diagnosed with high-grade prostate cancer (hazard ratio, 2.6; 95% CI, 1.4-4.8).
Men with male factor infertility were found to have an increased risk of subsequently developing high-grade prostate cancer. Male infertility may be an early and identifiable risk factor for the development of clinically significant prostate cancer.
已有研究报道称，父系身份可能是前列腺癌的一个危险因素。在本研究中，作者通过对评估不育症的男性队列进行研究，来探讨男性不育是否是前列腺癌的一个危险因素。
从加利福尼亚州的 15 家不育症中心确定了 1967 年至 1998 年间接受不育症评估的 22562 名男性，并与加利福尼亚癌症登记处相关联。将前列腺癌的发病率与年龄和地理位置匹配的一般人群中男性的发病率进行比较。采用 Cox 比例风险回归模型来对患有男性因素不育症和不患有男性因素不育症的男性的前列腺癌风险进行建模。
共发现 168 例前列腺癌病例，这些病例在不育症评估后发生。与一般人群相比，评估不育症但不一定有男性因素的男性并未发现癌症风险增加（标准化发病比 [SIR]，0.9；95%置信区间 [95%CI]，0.8-1.1）。对于患有男性因素不育症且发生高级别前列腺癌的男性，这种风险最高（SIR，2.0；95%CI，1.2-3.0）。多变量分析显示，患有男性因素不育症的男性被诊断为高级别前列腺癌的可能性是普通人群的 2.6 倍（风险比，2.6；95%CI，1.4-4.8）。
患有男性因素不育症的男性随后发生高级别前列腺癌的风险增加。男性不育可能是发生具有临床意义的前列腺癌的早期且可识别的危险因素。
