title: Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis.
abstract: OBJECTIVE
  We determined the standardized incidence ratio of testicular cancer in infertile men presenting with an abnormal semen analysis compared to the general population.
  
  
  METHODS
  The charts from more than 3,800 men presenting with infertility and abnormal semen analysis during a 10-year period were retrospectively reviewed. The incidence of testicular tumors diagnosed in this group was compared to that of race and age matched controls during the same period from the general population (as reported by the Surveillance, Epidemiology and End Results [SEER] database).
  
  
  RESULTS
  Of 3,847 men 10 (0.3%) with infertility and abnormal semen analysis were diagnosed with testicular tumors. Mean patient age was 32.6 years (range 25 to 52) and all 10 men were diagnosed with a seminomatous germ cell tumor. Two men had a history of cryptorchidism while the remaining 8 had no identifiable risk factors for testicular cancer. The SEER database reported an incidence of 10.6 cases of testicular cancer (95% CI 10.3-10.8) per 100,000 men of similar age group and racial composition during the same period. The standardized incidence ratio of testicular cancer was 22.9 (95% CI 22.4-23.5) when comparing our infertile group to the control population. Exclusion from analysis of the 2 patients with a history of cryptorchidism decreased the standardized incidence ratio to 18.3 (95% CI 18.0-18.8).
  
  
  CONCLUSIONS
  Infertile men with abnormal semen analyses have a 20-fold greater incidence of testicular cancer compared to the general population. Patients and physicians should be aware that one of the causes of infertility could be cancer, particularly testicular cancer.
authors.affiliation: Department of Urology, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Raman
authors.forename: Craig F
authors.initials: CF
authors.lastname: Nobert
authors.forename: Marc
authors.initials: M
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D007248:Infertility, Male / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009845:Oligospermia / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D018426:SEER Program; D012661:Semen / Q000166:cytology*; D018239:Seminoma / Q000453:epidemiology* / Q000473:pathology; D013076:Sperm Count; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014481:United States / Q000453:epidemiology