International trends in rates of hypospadias and cryptorchidism

Researchers from seven European nations and the United States have publishe d reports of increasing rates of hypospadias during the 1960s, 1970s, and 1 980s. Reports of increasing rates of cryptorchidism have come primarily fro m England, In recent years, these reports have become one focus of the deba te over endocrine disruption, This study examines more recent data from a l arger number of countries participating in the International Clearinghouse for Birch Defects Monitoring Systems (ICBDMS) to address the questions of w hether such increases are worldwide and continuing and whether there are ge ographic patterns to any observed increases. The ICBDMS headquarters and in dividual systems provided the data. Systems were categorized into five grou ps based on gross domestic product in 1984. Hypospadias increases were most marked in two American systems and in Scandinavia and Japan. The increases leveled off in many systems after 1985. Increases were not seen in less af fluent nations. Cryptorchidism rates were available for 10 systems. Clear i ncreases in this anomaly were seen in two U.S. systems and in the South Ame rican system, bur not elsewhere. Since 1985, rates declined in most systems . Numerous artifacts may contribute to or cause upward trends in hypospadia s Possible "real" causes include demographic changes and endocrine disrupti on among others.