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Adolescent and adult risk factors for testicular cancer

Nature Reviews Urology volume 9, pages 339–349 (2012)Cite this article

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Abstract

The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because the risk factors for the disease are poorly understood. Some research suggests that in utero exposures, or those in early childhood, are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolescence and adulthood is also linked to the development of testicular cancer. Of these, two adult occupational exposures—fire fighting and aircraft maintenance—and one environmental exposure (to organochlorine pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, seven of the identified factors—diet, types of physical activity, military service, police work as well as exposure to ionizing radiation, electricity and acrylamide—are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures—to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use—require further study to determine their association with testicular cancer.

Key Points

  • The incidence of testicular cancer has risen globally, particularly in the developed world, over the past several decades

  • The risk factors for testicular cancer are not well understood, but include prior cryptorchidism, prior unilateral testicular cancer and a family history of testicular cancer

  • The prevailing hypothesis in the aetiology of testicular cancer is that risk is largely determined in utero

  • However, emerging evidence suggests that exposure to risk factors in adolescence and adulthood might also promote testicular cancer, including exposure to certain pesticides or employment in occupations such as fire fighting or aircraft maintenance

  • Seven exposures—to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use—might have an association with testicular cancer

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Figure 1: Incidence rates of testicular cancer (per 100,000 man-years) age-standardized to the world population in 2008.

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Acknowledgements

The authors would like to thank Dr. Michael B. Cook for his suggestions and comments on the manuscript.

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  1. Division of Hormonal and Reproductive Epidemiology, National Cancer Institute, Suite 550 6120 Executive Boulevard, Rockville, 20852, MD, USA

    Katherine A. McGlynn & Britton Trabert

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  1. Katherine A. McGlynn
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Both authors contributed equally to the research, writing and editing of the manuscript before submission as well as to the discussions of its content.

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Correspondence to Katherine A. McGlynn.

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McGlynn, K., Trabert, B. Adolescent and adult risk factors for testicular cancer. Nat Rev Urol 9, 339–349 (2012). https://doi.org/10.1038/nrurol.2012.61

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