Skip to main content
. 2015 Mar 31;16(4):7230–7260. doi: 10.3390/ijms16047230

Table 2.

Epidemiologic studies of the association between male infertility and prostate cancer.

Author(s) Country and Year Design Subjects Finding(s) Conclusions
Giwercman et al. [150] Sweden 2005 Population-based case-control 48,850 cases of PC between 1958–1998. For each case, one control was matched by year of birth.

  1. Men being childless or having fathered one child only were associated with reduced risks for PC compared to cases having fathered 2 or more children (odds ratio of 0.83 and 0.93; respectively).

  2. There was no further change in risk associated with fathering of more than 2 children.

  3. The risk for PC was reduced among childless men.

 A dysfunctional reproductive system supporting the prostatic growth to a lesser extent could be a feasible underlying cause of this association.
Negri et al. [151] Italy 2006 Case-control study 1294 patients diagnosed with PC between 1991 and 2002, and 1451 controls as cases for a wide spectrum of acute and non-neoplastic conditions.

  1. Compared to men with 2 or more children, the odds ratio for childless men was 0.95 when adjusting only for age and geographic locality, and 1.10 after further adjustment for marital status and age at marriage.

  2. The odds ratio was adjusted to 1.00 when unmarried and separated/divorced men were accounted for, 1.09 in terms of men below 65 years of age and 1.13 with respect to cases above the age of 65 years.

  3. The odds ratio was 1.17 for men with only 1 child when compared to men who reported 2 or more children.

 The report concludes that the relation between the number of children and PC risk remains controversial.
Haralp et al. [152] Israel 2007 Cohort study 15,268 fathers followed for 28–41 years from the birth of a live offspring.

  1. 543 men with one or more stillborn offspring experienced an increased risk of PC (incidence ratio of 1.87).

  2. With one reported stillbirth, the risk ratio was 1.68 and with two or more, the risk ratio was 3.29.

 The study suggests that stillbirth and PC may have shared environmental causes. Genetic susceptibility to PC might increase the risk of a stillbirth in offspring.
Jørgensen et al. [149] Denmark 2008 Cohort study All men born in Denmark between 1935 and 1988, among whom 3400 developed PC during follow-ups between 1968 and 2003.

  1. Childless men were at a 16% reduced risk of PC compared with fathers (incidence ratio of 0.84).

  2. The sex of the offspring did not affect PC risk (odds ratio of 0.99).

  3. Among fathers, a significant trend was observed of gradually reduced PC risk with the increasing number of children.

 Men without children are at a moderately reduced risk of PC. Among men with children, there appears to be a linear decline in PC occurrence with an increasing number of children, independent of the sex of the offspring.
Ruhayel et al. [46] Sweden 2010 Case-control study 445 PC cases and 446 controls. 841 men were biological fathers and 50 men were infertile. Infertile men were at a significantly lower risk of being diagnosed with PC than fertile men (odds ratio of 0.45). Enduring male infertility may be associated with a reduced PC risk, validating the theory that normal testicular function and steroidogenesis are important factors to the later development of PC.
Walsh et al. [140] State of California, USA 2010 Population-based case-control A total of 22,562 patients being evaluated for infertility from 1967 to 1998, and linked to the cancer registry. The incidence of PC was compared with the incidence in an age- and geography-matched sample of men from the general population.

  1. 168 cases developed PC development after infertility diagnosis.

  2. Men evaluated for infertility but not specifically with male factors were not found to have an increased risk of cancer compared with the general population (incidence ratio of 0.9).

  3. The highest risk was found in cases with male factor infertility who developed high–grade PC (incidence ratio of 2.0).

  4. According to a multivariate analysis, men with male factor infertility were found to be 2.6 times more likely to be diagnosed with high–grade PC.

 Male infertility may be an early and identifiable risk factor for the development of clinically significant PC.
Wirén et al. [153] Sweden 2013 Population-based case-control 117,328 PC cases and 562,644 controls, matched on birth year and residence.

  1. Childless men had a decreased risk of PC when compared to fathers (odds ratio of 0.83) and the risk was lower for low-risk PC (odds ratio of 0.74) than for metastatic PC (odds ratio of 0.93).

  2. Adjustment for marital status and education narrowed the ratio in the low-risk category (0.87) whereas the odds ratio for metastatic cancer remained almost unchanged (0.92).

 The report claims that associations between the fatherhood status and PC are predominantly due to socioeconomic factors influencing health care-seeking behavior.