Risk factors for cancer of the testis in young men

Abstract

An individual matched case-control study of testis cancer in 131 men under age 40 was conducted to investigate antecedent risk factors including events during prenatal life. Ten patients were born with an undescended testis compared to only two controls (p less equal to 0.02), a previously reported risk factor. Two new risk factors were uncovered: six patients-mothers received hormones during the index pregnancy compared to only one control-mother, and eight patient-mothers and two control-mothers reported excessive nausea as a complication of the index pregnancy. A hypothesis linking these three factors is presented: viz, that a major risk factor for testis cancer is a relative excess of certain hormones (in particular estrogen) at the time of differentiation of the testes.

Testicular cancer risk and maternal parity: a population-based cohort study

“…However, the prevalence of cryptorchidism in patients with testicular cancer is only around 10% (United Kingdom Testicular Cancer Study Group, 1994;Schottenfeld, 1996) and therefore not likely in itself to account for the observed association between parity of the mother at birth and the risk of testicular cancer in the male offspring. Rather, our findings would be in line with the hypothesis that cryptorchidism and testicular cancer may be associated through shared risk factors (Henderson et al, 1979).…”

“…It has been hypothesized that high levels of endogenous oestrogens during critical stages of development in utero may increase the risk of cryptorchidism and testicular cancer (Henderson et al, 1979;, and at least three studies have found some evidence for increased oestrogen levels in first compared with later pregnancies (Bernstein et al, 1986;Panagiotopoulou et al, 1990;Key et al, 1996). Other studies also tend to support this hypothesis (McLachlan et al, 1975;Depue, 1984;Brown et al, 1986;Depue et al, 1983;Bernstein et al, 1988).…”

“…Several case-control studies Swerdlow et al, 1987;Prener et al, 1992;M0ller and Skakkebek, 1996), but not all (Morrison, 1976;Henderson et al, 1979;Brown et al, 1986;Akre et al, 1996), have reported an increased risk of testicular cancer in first-born compared with later born sons. If such an association exists it suggests a modifying effect of environmental factors on the risk of testicular cancer (MacMahon and Pugh, 1970;Khoury et al, 1993), factors that are likely to be operational during fetal life or early childhood.…”

Sports activities and risk of testicular cancer

“…Although the odds ratio we found was higher, it was based on rather small numbers. In other studies in which it has been examined (Schottenfeld et al, 1980; Henderson et al, 1979) the relative risks obtained have not been statistically significant, although all four studies are consistent with an elevated risk of about 2-3-fold. There were too few (6) cases of infantile inguinal hernia to examine the relationship between side of hernia and side of tumour in those not having cryptorchidism.…”

“…Recent case-control studies (Schottenfeld et al, 1980;Henderson et al, 1979), of testicular cancer in young men, have found comparatively high rates of cryptorchidism in both cases and controls. This has led to the suggestion (Schottenfeld et al, 1980) that cryptorchidism is increasing.…”