Wirén Sara, Drevin Linda, Akre Olof, Robinson David, Stattin Pär
Department of Surgery and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden.
PLoS One. 2014 Oct 22;9(10):e110506. doi: 10.1371/journal.pone.0110506. eCollection 2014.
An association between male fertility and risk of prostate cancer has been suggested, possibly through lower androgen levels in subfertile men. We evaluated male fertility in relation to risk of prostate cancer by assessing the frequency of fathering of dizygotic twins, a marker of high fertility, among cases of prostate cancer and controls.
We performed a case-control study in Prostate Cancer data Base Sweden (PCBaSe), a nationwide, population-based cohort. PCBaSe was linked to the Swedish twin register for information on zygosity for same-sex twins and to other nationwide health care registers and demographic databases for information on socioeconomic factors, comorbidity, and tumor characteristics for 96 301 prostate cancer cases and 378 583 matched controls. To account for the influence of in vitro fertilization on dizygotic twinning, analyses were restricted to men who had fathered children before 1991, when in vitro fertilization was still uncommon in Sweden.
1 112 cases and 4 538 controls had fathered dizygotic twins. Men with dizygotic twins had no increased risk of prostate cancer compared to fathers of singletons; neither for total prostate cancer odds ratio (OR) 0.95(95% CI 0.89-1.02), nor for any risk category, OR 0.97 (95% CI 0.84-1.12) for low-risk disease, and OR 1.04 (95% CI 0.90-1.22) for metastatic disease.
The lack of association between fathering of dizygotic twins and prostate cancer risk give no support for an association between male fertility and prostate cancer risk.
已有研究表明男性生育能力与前列腺癌风险之间存在关联，可能是由于生育能力低下的男性雄激素水平较低。我们通过评估前列腺癌病例和对照中双卵双胞胎（高生育能力的一个标志）的生育频率，来研究男性生育能力与前列腺癌风险之间的关系。
我们在瑞典前列腺癌数据库（PCBaSe）中进行了一项病例对照研究，该数据库是一个全国性的基于人群的队列。PCBaSe与瑞典双胞胎登记处相链接，以获取同性双胞胎的合子性信息，并与其他全国性医疗保健登记处和人口数据库相链接，以获取96301例前列腺癌病例和378583例匹配对照的社会经济因素、合并症和肿瘤特征信息。为了考虑体外受精对双卵双胞胎的影响，分析仅限于1991年之前生育子女的男性，当时体外受精在瑞典仍不常见。
1112例病例和4538例对照生育了双卵双胞胎。与单胎父亲相比，生育双卵双胞胎的男性患前列腺癌的风险没有增加；无论是总体前列腺癌优势比（OR）为0.95（95%CI 0.89-1.02），还是任何风险类别，低风险疾病的OR为0.97（95%CI 0.84-1.12），转移性疾病的OR为1.04（95%CI 0.90-1.22）。
双卵双胞胎生育与前列腺癌风险之间缺乏关联，不支持男性生育能力与前列腺癌风险之间存在关联。
