Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy; Department of Urology, School of Medicine, Stanford University, Stanford, California.
Department of Urology, School of Medicine, Stanford University, Stanford, California.
Fertil Steril. 2020 Nov;114(5):984-996. doi: 10.1016/j.fertnstert.2020.04.042. Epub 2020 Jul 22.
To investigate the current evidence that correlates impaired male fertility with the risk of developing male-related malignancies.
Systematic review and meta-analysis of population-based retrospective cohort studies.
Not applicable.
PATIENT(S): Men diagnosed with impaired fertility status and subsequently observed to determine incidence risk in developing testicular cancer (TCa) or prostate cancer (PCa).
INTERVENTION(S): Not applicable.
MAIN OUTCOME MEASURE(S): Pooled risk ratio (RR) differences among male factor infertility subjects compared with a fertile control population, and meta-regression analysis according to age at baseline, mean follow-up, range of study time, and year of publication.
RESULT(S): Six studies met the inclusion criteria and were critically examined. Four studies examined male infertility and TCa (n = 161,634; 174 TCa cases), and four examined infertility in relation to PCa (n = 183,950 men; 377 PCa cases) from 1963 to 2014. The pooled RR was 2.033 (95% confidence interval [CI], 1.66-2.48); heterogeneity: Q = 3.04 (degree of freedom [df] = 3); I = 1.55% for TCa and 1.68 (95% CI, 1.17-2.4); Q = 23.3(df = 3); I = 87.1% for PCa.
CONCLUSION(S): Male infertility was associated with a subsequent risk of both TCa and PCa. Although the clinical significance of these findings remains uncertain, future studies should evaluate the underlying mechanisms to determine whether testis and prostate screening practices should be altered in men with male infertility.
PROSPERO 167277.
调查与男性生育力受损相关的男性相关恶性肿瘤发病风险的现有证据。
基于人群的回顾性队列研究的系统评价和荟萃分析。
不适用。
被诊断为生育力受损的男性，并随后观察以确定发生睾丸癌（TCa）或前列腺癌（PCa）的风险。
不适用。
与生育能力正常的对照组相比，男性因素不育患者的汇总风险比（RR）差异，以及根据基线年龄、平均随访时间、研究时间范围和发表年份的meta 回归分析。
符合纳入标准并经过严格审查的研究有 6 项。其中 4 项研究探讨了男性不育与 TCa（n = 161634；174 例 TCa 病例）之间的关系，4 项研究探讨了不育与 PCa（n = 183950 名男性；377 例 PCa 病例）之间的关系，研究时间为 1963 年至 2014 年。汇总 RR 为 2.033（95%置信区间[CI]，1.66-2.48）；异质性：Q = 3.04（自由度[df] = 3）；I = 1.55%用于 TCa 和 1.68（95% CI，1.17-2.4）；Q = 23.3（df = 3）；I = 87.1%用于 PCa。
男性不育与随后发生 TCa 和 PCa 的风险相关。尽管这些发现的临床意义尚不确定，但未来的研究应评估潜在的机制，以确定是否应改变男性不育患者的睾丸和前列腺筛查实践。
PROSPERO 167277。
