History of Testicular Cancer Increases Risk for Aggressive Prostate Cancer Later on

March 2015, Vol 6, No 2

Orlando, FL—Previous studies have shown that a history of testicular cancer increases the risk for developing prostate cancer. A new study presented at the 2015 Genitourinary Cancers Symposium shows, for the first time ever, a link between a history of testicular cancer and an increased likelihood of intermediate- and high-risk prostate cancer sometime in the future.

This case-control study included approximately 180,000 men from the Surveillance, Epidemiology, and End Results registry, of whom 32,435 men had a history of testicular cancer and 147,044 had a history of melanoma. Melanoma was selected as a control cancer, because it has no known link to prostate cancer.

First Evidence for a New Biologic Link

By age 80 years, 12.6% of men with a history of testicular cancer developed prostate cancer compared with only 2.8% of those with no such history, an almost 10% increase in risk. The incidence of intermediate- or high-risk prostate cancer was 5.8% in those with a history of testicular cancer versus 1.1% in those with no such history. Overall, a history of testicular cancer was associated with a 4.7-fold increased risk for prostate cancer and a 5.2-fold increased risk for intermediate- or high-risk disease.

“This study should alert men with a history of testicular cancer to be more proactive about discussing screening for prostate cancer risk with their doctors,” said senior study investigator Mohummad Minhaj Siddiqui, MD, of the University of Maryland School of Medicine, and Director of Urologic Robotic Surgery, University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore.

After controlling for other risk factors for prostate cancer, including age, race, and previous radiotherapy, there was still an increased risk for prostate cancer and intermediate- and high-risk prostate cancer in men with a history of testicular cancer. However, the absolute risk for developing intermediate- or high-risk cancer was relatively low, Dr Siddiqui pointed out—approximately 5.8%.

“Ninety-five percent of men who have had testicular cancer will not develop aggressive prostate cancer,” he said. Nevertheless, the results should encourage close follow-up of men who have had testicular cancer, he noted.

“This study is suggestive, and we need further validation studies to establish this association with certainty,” Dr Siddiqui said. He emphasized his hopes that these findings will prompt further research on the biologic link between these 2 diseases.

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