Risk factors for testicular germ cell tumours by histological tumour type

Article metrics


There are two main histological groups of testicular germ cell tumours, which may have different risk factors. Some authors have analysed potential risk factors by histological group but few consistent differences have been identified. In this paper we examine risk factors for pure seminoma and other tumours using data from the United Kingdom case control study of testicular cancer. Seven hundred and ninety-four cases were included in the study, each with a matched control; 400 cases had pure seminoma tumours, and 394 had other testicular tumours. The risk of seminoma associated with undescended testis was slightly higher than that for other tumours (odds ratio of 5.3 compared with 3.0). When split at the median age at diagnosis, this difference was greater in men aged 32 and over (odds ratio of 11.9 compared with 5.1) than in the younger men (3.0 compared with 2.5). Risks associated with testicular or groin injuries were higher in the non-seminoma group, as was the risk for a history of sexually transmitted disease. The protective effect of a late puberty was more marked for tumours of other histologies. Some differences were also detected for participation in sports. Whilst some of the differences detected may have arisen by chance, the stronger association between undescended testis and pure seminoma has been identified by a number of other studies and may reflect a genuine difference in aetiology.

Change history

  • 16 November 2011

    This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication


  1. Carlsen, E., Giwercman, A., Keiding, N. & Skakkebaek, N. E. (1995). Declining semen quality and increasing incidence of testicular cancer: is there a common cause? Environ Health Perspect 103: 137–139.

  2. Coldman, A. J., Elwood, J. M. & Gallagher, R. P. (1982). Sports activities and risk of testicular cancer. Br J Cancer 46: 749–756.

  3. Coupland, C. A. C., Chilvers, C. E. D., Pike, M. C., Davey, G. & Forman, D. (1998). Differences in the aetiology of testicular cancer by histological tumour type. In Germ Cell Tumours IV, Jones WG, Appleyard I, Harnden P and Joffe JK (eds), pp. 9–16. John Libbey: London

  4. Gallagher, R. P., Huchcroft, S., Phillips, N., Hill, G. B., Coldman, A. J., Coppin, C. & Lee, T. (1995). Physical activity, medical history, and risk of testicular cancer (Alberta and British Columbia, Canada). Cancer Causes Control 6: 398–406.

  5. Haughey, B. P., Graham, S., Brasure, J., Zielezny, M., Sufrin, G. & Burnett, W. S. (1989). The epidemiology of testicular cancer in upstate New York. Am J Epidemiol 130: 25–36.

  6. Hayes, R. B., Morris Brown, L., Pottern, L. M., Gomez, M., Kardaun, J. W., Hoover, R. N., O’Connell, K. J., Sutzman, R. E. & Jaradpour, N. (1990). Occupation and risk for testicular cancer: a case-control study. Int J Epidemiol 19: 825–831.

  7. Henderson, B. E., Benton, B., Jing, J., Yu, M. C. & Pike, M. C. (1979). Risk factors for cancer of the testis in young men. Int J Cancer 23: 598–602.

  8. Knight, J. A., Marrett, L. D. & Weir, H. K. (1996). Occupation and risk of germ cell testicular cancer by histologic type in Ontario. J Occ Env Med 38: 884–890.

  9. Looijenga, L. H., Gillis, A. J., Van Putten, W. L. & Oosterhuis, J. W. (1993). In situ numeric analysis of centromeric regions of chromosomes 1, 12 and 15 of seminomas, nonseminomatous germ cell tumours, and carcinoma in situ of human testis. Lab Invest 68: 211–219.

  10. Møller, H. (1993). Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology. Eur Urol 23: 8–13.

  11. Møller, H. & Skakkebæk, N. E. (1996). Risks of testicular cancer and cryptorchidism in relation to socio-economic status and related factors: case-control studies in Denmark. Int J Cancer 66: 287–293.

  12. Møller, H., Prener, A. & Skakkebæk, N. E. (1996). Testicular cancer, cryptorchidism, inguinal hernia, testicular atrophy, and genital malformations: case-control studies in Denmark. Cancer Causes Control 7: 264–274.

  13. Morrison, A. S. (1976). Cryptorchidism, hernia and cancer of the testis. J Natl Cancer Inst 56: 731–733.

  14. Moss, A. R., Osmond, D., Bacchetti, P., Torti, M. & Gurgin, V. (1986). Hormonal risk factors in testicular cancer. A case-control study. Am J Epidemiol 124: 39–52.

  15. Oliver, R. T. D. (1990). Atrophy, hormones, genes and viruses in aetiology germ cell tumours. Cancer Surv 9: 263–286.

  16. Oliver, R. T. D., Leahy, M. & Ong, J. (1995). Combined seminoma/non-seminoma should be considered as intermediate grade germ cell cancer (GCC). Eur J Cancer 31: 1392–1394.

  17. Prener, A., Engholm, G. & Jenson, O. M. (1996). Genital anomalies and risk for testicular cancer in Danish men. Epidemiology 7: 14–19.

  18. Stone, J. M., Cruickshank, D. G., Sandeman, T. F. & Matthews, J. P. (1991). Laterality, maldescent, trauma and other clinical factors in the epidemiology of testis cancer in Victoria, Australia. Br J Cancer 64: 132–138.

  19. Strader, C. H., Weiss, N. S., Daling, J. R., Karagas, M. R. & McKnight, B. (1988). Cryptorchism, orchiopexy, and the risk of testicular cancer. Am J Epidemiol 127: 1013–1018.

  20. Swerdlow, A. J., Huttly, S. R. A. & Smith, P. G. (1987). Testicular cancer and antecedent diseases. Br J Cancer 55: 97–103.

  21. Swerdlow, A. J., Higgins, C. D. & Pike, M. C. (1997). Risk of testicular cancer in cohort of boys with cryptorchidism. Br Med J 314: 1507–1511.

  22. UK Testicular Cancer Study Group (1994a). Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility and exercise. Br Med J 308: 1393–1399.

  23. UK Testicular Cancer Study Group (1994b). Social, behavioural and medical factors in the aetiology of testicular cancer: results from the UK study. Br J Cancer 70: 513–520.

Download references

Author information

Rights and permissions

From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/

Reprints and Permissions

About this article

Cite this article

Coupland, C., Chilvers, C., Davey, G. et al. Risk factors for testicular germ cell tumours by histological tumour type. Br J Cancer 80, 1859–1863 (1999) doi:10.1038/sj.bjc.6690611

Download citation


  • case-control study
  • histology
  • risk factors
  • seminoma
  • testicular cancer

Further reading