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BMJ No 7114 Volume 315 Papers - Abstracts Saturday 18 October 1997
Prevalence of carcinoma in situ of the testis in 207
oligozoospermic men from infertile couples: prospective study of
testicular biopsies Prevalence of carcinoma in situ of the testis in 207 oligozoospermic men from infertile couples: prospective study of testicular biopsiesAleksander Giwercman, Jorn Kvist Thomsen, Jens Hertz, Jorgen G Berthelsen, Vibeke Jensen, Birgit Meinecke, Lene Thormann, Hans H Storm, Niels E Skakkebjk AbstractObjective: To investigate the prevalence of carcinoma in situ of the testis in a group of oligozoospermic men from infertile couples.Design: A consecutive group of oligozoospermic men from infertile couples were offered bilateral testicular biopsy. The observed prevalence of carcinoma in situ was compared with the expected prevalence of testicular cancer in a corresponding age matched population of Danish men, assuming all untreated cases of carcinoma in situ progress to tumour stage. This calculation was based on data from the Danish Cancer Registry. Subjects: 207 men aged 18-50 years who had sperm density below 10 million/ml in two samples within the previous 2 years or sperm density below 20 million/ml in two samples within the previous 2 years and a history of cryptorchidism or one or two atrophic testicles (orchidometer volume less than 15 cm3), or both. Interventions: Bilateral testicular biopsies. Main outcome measures: Carcinoma in situ in the biopsy specimen. Results: No case of carcinoma in situ was found among the 207 men. The expected number in a normal age matched population of corresponding size was 0.8. Conclusion: There is no increase in risk of carcinoma in situ of the testis in moderately oligozoospermic men of couples referred because of infertility. University Department of Growth University Department of Gynaecology University Department of Department of
Gynaecology University Department
of Gynaecology Danish Cancer Registry, Correspondence to: Dr Giwercman
Sociodemographic and morbidity indicators of need in relation to the use of community health services: observational studyKen Buckingham, Peter R Freeman See editorial by Sheldon AbstractObjective: To examine whether the sociodemographic and morbidity characteristics of populations influence their use of the following community health services: district nursing, health visiting, chiropody, community maternity, community mental illness, and the professions allied to medicine.Design: Observational study. Setting: Nationally representative sample of provider trusts in England. Main outcome measures: Activity levels for each service calculated for enumeration districts within the catchment areas of the sample of trusts and standardised to allow for differences in age structure. Regression analysis to determine whether the standardised activity rates for each service could be predicted by a range of socio-demographic and morbidity proxies. Results: Morbidity or deprivation, or both, seemed to influence the use of services in each of the care programmes examined. Conclusions: The allocation of funds for community health services should allow for differences in the health and socio-demographic characteristics of health authorities. Department of Primary Health Care Ship
Cottage,
Correspondence to: Dr Buckingham
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