Laterality, maldescent, trauma and other clinical factors in the epidemiology of testis cancer in Victoria, Australia

Abstract

Summary Clinical factors were studied in a population based survey of 1,1 16 cases of testicular neoplasms in Victoria, Australia, between 1950 and1978. The ratio of right to left sided tumours was 54:46, but the left side predominated among sarcomas (P = 0.006), and in older men. The relative risk (RR) for men with unilateral maldescent was 15 (CI 10-23) and for men with bilateral maldescent 33 (CI 20-55) (odds ratio 1.4, CI 0.5-4, P = 0.7). Calculations per testis in men with unilateral maldescent showed an elevated risk for both the maldescended testis (RR 28, P<0.0001) and the normally descended testis (RR 3, CI 1.2-6, P = 0.04). The RR for men with abdominal maldescent was 55 (CI 36-83) compared to 7 (CI 4-11) for those with inguinal maldescent (odds ratio 8, CI 3-20, P<0.0001). Seminomas were more common than nonseminomas (NSGCT) in men with a history of maldescent (odds ratio 1.7, CI 1.1 -3, P = 0.02) and also among corrected cryptorchids compared to uncorrected (P = 0.005). Seminomas were diagnosed at an earlier median age in men with corrected cryptorchid testes compared to uncorrected (P = 0.03) and in men with corrected cryptorchid testes compared to normally descended (P = 0.001). Maldescent was also associated with hernia (P = 0.04). Twenty-eight per cent of patients recorded a history of trauma with a higher proportion among NSGCT than among seminomas (P = 0.03). Prior malignancies were reported in nine patients, compared to 3.6 expected; prostate cancer (2) and malignant melanoma (2) were the greatest contributors to the excess.

Risk factors for testicular germ cell tumours by histological tumour type

“…This would suggest considering this group separately where numbers are sufficient, as proposed by Oliver et al (1995). Two other studies (Swerdlow et al, 1987;Stone et al, 1991) have found, as we did a tendency for late corrected or uncorrected undescended testis to predispose to pure seminoma, the consistency of these findings, albeit in a rather small subgroup, again suggests a real effect.…”

“…In order to reduce recall bias for testicular trauma, mother's questionnaires and GP notes were used to verify these reports. Only two other studies to our knowledge have investigated the role of trauma by histological group, the study by Stone et al (1991) found, like us, increased levels of trauma in non-seminoma cases, whereas Haughey et al (1989) reported no difference.…”

“…Among the authors who have examined risks separately, Morrison (1976), Stone et al (1991) and Prener et al (1996) found a significantly stronger association with seminoma, Morrison (1976) for example reported OR of 15.6 for pure seminoma compared with 5.3 for non-seminoma, and Prener et al (1996) reported OR of 7.3 and 3.6 respectively. Henderson et al (1979), Moss et al (1986), Swerdlow et al (1987), Strader et al (1988), Haughey et al (1989), Gallagher et al (1995) and reported similar risks associated with undescended testis in the two histological groups, although where separate OR were presented, they were consistently higher for seminomas than other tumours (Moss et al, 1986;Swerdlow et al, 1987;Strader et al, 1988;.…”

Epidemiology of testicular cancer: An overview

“…33 Although mumps orchitis has been studied most frequently, the majority of these studies have failed to demonstrate a significant association with testicular cancer. 18,24,48,112,129,130 …”

“…Many diseases have been examined in relation to testicular cancer, including mumps orchitis, 18,24,48,100,112,129,130 spina bifida, 131 neonatal jaundice, 44 hydrocele, 100 sexually transmitted diseases, 129 polythelia 132 and mononucleosis. 33 Although mumps orchitis has been studied most frequently, the majority of these studies have failed to demonstrate a significant association with testicular cancer.…”