LOS ANGELES — Men who have difficulty conceiving children are 2.6 times as likely to have highly aggressive prostate cancer and 60 percent more likely to have slow-growing tumors, researchers reported Monday.
Although the absolute risk of developing prostate cancer was still low in these men, the findings suggest that such men should be screened for prostate cancer at an earlier age, said Dr. Otis Brawley, chief medical officer of the American Cancer Society.
Dr. Thomas J. Walsh of the University of Washington School of Medicine and his colleagues studied 22,562 men who had been evaluated from 1967 to 1998 at 15 California infertility centers, comparing them with a similar group of healthy men from the general population.
Overall, 0.4 percent of the fertile men developed prostate cancer during the decade of follow-up, compared with 1.2 percent of those diagnosed as infertile. Taking age into account, that translated to a 160 percent increased risk of developing aggressive tumors and a 60 percent increased risk of developing slow-growing tumors, the team reported.
It is not clear why infertile men have a higher risk. Walsh speculated that the risk might result from exposure to environmental toxins in the womb that cause damage to the male chromosome, but he argued that more research needs to be done.
Prostate cancer is the most common cancer in men after skin cancer, striking 192,000 American men each year and killing 27,000. Other risk factors include older age, a family history of the disease, obesity and being African-American.
Most national organizations recommend that men be offered screening beginning at age 50, but some critics argue that the screening leads to an unacceptably high rate of invasive procedures in men who do not have cancer, leading to impotence and other problems.
