Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Male Reproductive Medicine and Surgery Program, Departments of Urology and Obstetrics and Gynecology, Stanford University, Stanford, California.
Fertil Steril. 2018 Jan;109(1):6-19. doi: 10.1016/j.fertnstert.2017.11.005.
Associations between male infertility and cancer are gaining clinical attention. Relationships between infertility and cancer have traditionally been studied in women, but recent work has focused on the male component of reproduction. Infertile men are at an elevated risk to develop various malignancies later in life, primarily genitourinary malignancies such as testicular and prostate cancer. Rates of testicular and high-grade prostate cancer in infertile men appear to be at least double the risk in the general population. The link between infertility and malignancy highlights the importance of thorough evaluation and long-term follow up-beyond a simple semen analysis. A detailed urologic evaluation, possibly including scrotal ultrasound, may be beneficial to screen infertile men for testicular cancer. Publications have also demonstrated that male infertility can be a biomarker for cancer risk in first- and second-degree relatives. Testicular cancer risk in first-degree relatives of infertile men is 52% higher than the risk in relatives of fertile control men, and male infertility has been associated with a two- to threefold elevation in risk of childhood cancer in the siblings of infertile men. Links between infertility and malignancy are multifactorial, and exact mechanistic explanations are still not fully understood. Although more studies are needed to assess levels of risk and create screening recommendations in this population, understanding the relationship between male infertility and malignancy is crucial to provide comprehensive counseling for infertile men and their families.
男性不育与癌症之间的关联正引起临床关注。不孕与癌症之间的关系传统上在女性中进行研究，但最近的研究工作集中在生殖的男性方面。不育男性在以后的生活中患各种恶性肿瘤的风险增加，主要是生殖泌尿系统恶性肿瘤，如睾丸癌和前列腺癌。不育男性的睾丸癌和高级别前列腺癌的发病率似乎至少是普通人群的两倍。不育与恶性肿瘤之间的联系强调了彻底评估和长期随访的重要性-超出简单的精液分析。详细的泌尿科评估，可能包括阴囊超声检查，可能有助于对不育男性进行睾丸癌筛查。出版物还表明，男性不育可能是一级和二级亲属癌症风险的生物标志物。不育男性一级亲属的睾丸癌风险比生育控制男性亲属的风险高 52%，并且男性不育与不育男性兄弟姐妹的儿童癌症风险增加 2 至 3 倍有关。不育与恶性肿瘤之间的联系是多因素的，确切的机制解释仍不完全清楚。尽管需要更多的研究来评估该人群的风险水平并制定筛查建议，但了解男性不育与恶性肿瘤之间的关系对于为不育男性及其家人提供全面咨询至关重要。
