Subfertility and the risk of testicular germ cell tumors (United States)

Objectives: Previous studies have reported an association between subfertility and the risk of testicular germ cell tumors. We examined fertility, measured by number of children fathered and prior diagnosis of infertility, as a risk factor for testicular cancer, while accounting for the influence of occult cancer and cryptorchidism. Methods: Tumor registry data were used to identify 329 cases of testicular cancer in white men aged 20 to 69 years, diagnosed in western Washington State from 1977 to 1983; 672 cancer-free controls were identified by random-digit dialing. Telephone interviews ascertained reproductive histories and basic demographic information. Logistic regression was used to estimate the relative risk of testicular cancer associated with fertility. Results: Testicular cancer risk was decreased among men who had previously fathered a child (age-adjusted odds ratio (OR) 0.76, 95% confidence interval (CI): 0.54-1.06). Inverse associations were seen for seminomas and non-seminomas, and only slight attenuations in the ORs were observed when men with a history of cryptorchidism were excluded. Prior diagnosis of infertility was associated with an increased risk of testicular cancer (OR 2.40, 95% CI: 1.00-5.77). Conclusions: These results are consistent with an increased risk of testicular cancer among men with reduced fertility that goes beyond the effects of cryptorchidism.