Lifetime growth and risk of testicular cancer

Abstract

Adult height is associated with testicular cancer risk. We studied to what extent this association is explained by parental height, childhood height and age at puberty. We conducted a case-control study on germ-cell testicular cancer patients diagnosed in [1997][1998][1999][2000][2001][2002][2003][2004][2005][2006][2007][2008] and resident in the Province of Turin. Information was collected using mailed questionnaires in 2008-2011. Specifically, we asked for adult height (in cm), height at age 9 and 13 (compared to peers) and age at puberty (compared to peers). We also asked for paternal and maternal height (in cm) as indicators of genetic components of adult height. The analysis included 255 cases and 459 controls. Odds ratios (ORs) of testicular cancer were estimated for the different anthropometric variables. Adult height was associated with testicular cancer risk [OR: 1.16, 95% confidence interval (CI): 1.03-1.31 per 5-cm increase]. The risk of testicular cancer was only slightly increased for being taller vs. shorter than peers at age 9 (OR: 1.55, 95% CI: 0.91-2.64) or age 13 (OR: 1.26, 95% CI: 0.78-2.01), and parental height was not associated with testicular cancer risk. The OR for adult height was 1.32 (95% CI: 1.12-1.56) after adjustment for parental height. Among participants with small average parental height (<167 cm or less), the OR of testicular cancer for tall (>180 cm) vs. short (<174 cm) subjects was 3.47 (95% CI: 1.60-7.51). These results suggest that the association between height and testicular cancer is likely to be explained by environmental factors affecting growth in early life, childhood and adolescence.Testicular cancer is the most frequent male tumour among young adults and has been increasing in incidence over the last few decades in many populations.1 Its aetiology is still largely unknown. Cryptorchidism, family history, history of testicular cancer and ethnicity are established risk factors, 2 and prenatal exposures are likely to play a role. 3,4 Adult height has been repeatedly associated with an increased risk of testicular cancer. A recent meta-analysis estimated a 13% increase in risk with each 5-cm increase in adult height.5 Indeed, height is at present the strongest potential risk factor for testicular cancer, in terms of the population attributable risk. However, height is considered to be affected by both environmental and genetic factors, and the possible explanations for the association between height and testicular cancer have not been fully investigated.6,7 Adult height could be a proxy for genetic variants associated with the risk of testicular cancer or it could be a proxy for environmental exposures causing testicular cancer. Furthermore, these environmental exposures could act at different stages of life from the prenatal life to childhood and adolescence and it would be important to identify whether there are specific periods (for example, prenatal life or childhood) in which height-related environmental exposures could affect the risk of testicular cancer.In the a...

Testicular cancer in two brothers of a quadruplet: a case report and a review of literature

“…Genes associated with malignant transformation, proliferation, stemness and pluripotency (KRAS, CCND2, STELLA, NANOG) are located within this region, often amplified in testicular GCT (25,26). Gains of chromosomes 7,8,21, and X are reported in testicular GCT as well (23,25,27). Further genome-wide association studies identified six more loci implicated in testicular GCT, also suggesting the initiation stage in utero [28][29][30].…”

Postnatal risk factors for testicular cancer: The EPSAM case–control study

“…The EPSAM study is a population‐based case–control study on germ‐cell testicular cancer diagnosed between 1997 and 2008 among residents of the province of Turin, Italy. Full details of our study design have been described elsewhere . The study was approved by the local Ethical Committee and informed consent was obtained from each subject.…”

Baldness and testicular cancer: the EPSAM case–control study

“…Full details of the study design have been described elsewhere (Richiardi et al, 2014). The study was approved by the local Ethical Committee and informed consent was obtained from each subject.…”

“…The incidence of testicular cancer has been steadily increasing over the last decades in several populations (Bray et al, 2006) for unknown reasons. There are few established risk factors of testicular cancer: age, geographical area, cryptorchidism, contralateral testicular cancer, height, family history and ethnicity (Richiardi et al, 2008).…”