Skip to main content

Advertisement

SpringerLink
Log in

Maternal health and pre- and perinatal characteristics in the etiology of testicular cancer: a prospective population- and register-based study on Norwegian males born between 1967 and 1995

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objectives: The aim of the present prospective study was to identify possible risk factors of testicular cancer (TC) in relation to gestation and birth.Methods: Based on data from compulsory birth and cancer registration in Norway, odds ratios (ORs) of TC were estimated.

Results: Among 868068 males born between 1967 and 1995, 268 cases of germ cancer had developed by June 1996, 32 TCs before 5 years of age and 236 TCs thereafter, 48 cases being seminomas and 220 non-seminomas. There was a tendency of an inverse association between parity and TC. A previous finding from Sweden linking neonatal jaundice to risk of non-seminomas was confirmed (adjusted OR=2.1, 95 percent confidence interval [CI]=1.3-6.9). Significant associations were also seen for seminomas and TC diagnosed after 5 years of age. Maternal disease diagnosed before pregnancy increased the risk of TC significantly, particularly in the age group 0-4 years: Adjusted OR=3.0, CI=1.4-6.3. Retained placenta was significantly associated with both seminomas and non-seminomas and with TC diagnosed after 5 years of age.

Conclusions: The findings of this study support the existing hypothesis that pre- and perinatal risk factors are of significance for development of TC in children and in young adults, and for seminomas and non-seminomas. The hypothesis that estrogens are involved in TC development was, among other factors, supported by the association of parity to TC. Additionally, on the basis of findings in maternal diseases and complications to pregnancy, we suggest that immune reactions during foetal life may be of significance for development of TC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Holte T, Hansen S, Næss Å, Parr E. Cancer in Norway 1993. Oslo: The Cancer Registry of Norway, Institute of Epidemiological Cancer Research, 1996.

    Google Scholar 

  2. Wanderås EH, Tretli S, Fosså S. Trends in incidence of testicular cancer in Norway 1955-1992. Eur J Cancer 1995; 31A: 2044–8.

    Article  PubMed  Google Scholar 

  3. Wanderås EH, Fosså SD, Tretli S. Risk of a second germ cell cancer after treatment of primary germ cell cancer in 2201 Norwegian male patients. Eur J Cancer 1997; 33: 244–52.

    Article  PubMed  Google Scholar 

  4. Østerlind A, Berthelsen JG, Abildgaard N, et al. Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984. J Natl Cancer Inst 1991; 83: 1391–5.

    PubMed  Google Scholar 

  5. Giwercman A, Grindsted J, Hansen B, Jensen OM, Skakkebæk NE. Testicular cancer risk in boys with maldescended testis: a cohort study. J Urol 1987; 138: 1214–6.

    PubMed  Google Scholar 

  6. Swerdlow AJ, Huttly SR, Smith PG. Testicular cancer and antecedent diseases. Prenatal and familial association of testicular cancer. Br J Cancer 1987; 55: 571–7.

    PubMed  Google Scholar 

  7. Pottern LM, Brown LM, Hoover RN. Testicular cancer risk among young men: role of cryptorchidism and inguinal hernia. J Natl Cancer Inst 1985; 74: 377–81.

    PubMed  Google Scholar 

  8. M¢ller H, Prener A, Skakkebæk N. Testicular cancer, cryptorchidism, inguinal hernia, testicular atrophy, and genital malformations: case-control studies in Denmark. Cancer Causes Control 1996; 7: 264–74.

    PubMed  Google Scholar 

  9. Forman D, Pike MC, Davey G, et al. Aetiology of testicular cancer: association with congenital abnormalities, age puberty, infertility, and exercise. United Kingdom Testicular Cancer Study Group. BMJ 1994; 308: 1393–9.

    PubMed  Google Scholar 

  10. Heimdal K, Olsson H, Tretli S, Flodgren P, Børresen A, Fosså SD. Familial testicular cancer in Norway and Southern Sweden. Br J Cancer 1996; 73: 964–9.

    PubMed  Google Scholar 

  11. Forman D, Oliver RT, Brett AR, et al. Familial testicular cancer: a report of the UK family register, estimation of risk and an HLA class 1 sib-pair analysis. Br J Cancer 1992; 65: 255–62.

    PubMed  Google Scholar 

  12. Cancer Incidence in Five Continents. Comparability and quality of data. Lyon, France: IARC Scientific Publications no. 120, 1992; 972–3.

  13. Spitz MR, Sider JG, Pollack ES, Lynch HK, Newell GR. Incidence and descriptive features of testicular cancer among United States whites, blacks and hispanics, 1973-1982. Cancer 1986; 58: 1785–90.

    PubMed  Google Scholar 

  14. Adami HO, Bergström R, Möhner M, et al. Testicular cancer in nine northern European countries. Int J Cancer 1994; 59: 33–8.

    PubMed  Google Scholar 

  15. Giwercman A, Müller J, Skakkebæk NE. Prevalence of carcinoma in situ and other histopathological abnormalities in tests from 399 men who died suddenly and unexpectedly. J Urol 1991; 145: 77–80.

    PubMed  Google Scholar 

  16. vonder Maase H, Rørth M, WalbomJørgensen S, et al. Carcinoma in situ of contralateral testis in patients with testicular germ cell cancer: study of 27 cases in 500 patients. Br Med J Clin Res Ed 1986; 293: 1398–401.

    PubMed  Google Scholar 

  17. Gondos B. Ultrastructure of developing and malignant germ cells. Eur Urol 1993; 23: 68–74.

    Google Scholar 

  18. Skakkebæk NE, Berthelsen JG, Giwercman A, Müller J. Carcinoma-in-situ of the testis: possible origin from gonocytes and precursor of all types of germs cell tumours except spermatocytoma. Int J Androl 1987; 10: 19–28.

    PubMed  Google Scholar 

  19. Akre O, Ekbom A, Hsieh CC, Trichopoulos D, Adami HO.Testicular nonseminoma and seminoma in relation to perinatal characteristics. J Natl Cancer Inst 1996; 88: 883–9.

    PubMed  Google Scholar 

  20. Prener A, Hsieh CC, Engholm G, Trichopoulos D, Jensen OM. Birth order and risk of testicular cancer. Cancer Causes Control 1992; 3: 265–72.

    PubMed  Google Scholar 

  21. Swerdlow AJ, Huttly SR, Smith PG. Prenatal and familial associations of testicular cancer. Br J Cancer 1987; 55: 571–7.

    PubMed  Google Scholar 

  22. M¢ller H, Skakkebæk NE. Testicular cancer and cryptorchidism in relation to prenatal factors: case-control studies in Denmark. Cancer Causes Control 1997; 8: 904–12.

    Article  PubMed  Google Scholar 

  23. Henderson BE, Benton B, Jing J, Mimi CY, Pike MC. Risk factors for cancer of the testis in young men. Int J Cancer 1979; 23: 598–602.

    PubMed  Google Scholar 

  24. Gershman ST, Stolley PD. A case-control study of testicular cancer using Connecticut tumour registry data. Int J Epidemiol 1988; 17: 738–42.

    PubMed  Google Scholar 

  25. Brown LM, Pottern LM, Hoover RN. Prenatal and perinatal risk factors for testicular cancer. Cancer Res 1986; 46: 4812–6.

    PubMed  Google Scholar 

  26. Swerdlow AJ, Stiller CA, KinnierWilson LM. Prenatal factors in the aetiology of testicular cancer: an epidemiological study of childhood testicular cancer deaths in Great Britain, 1953-73. J Epidemiol and Common Health 1982; 36: 96–101.

    Google Scholar 

  27. Shu XO, Nesbit ME, Buckley JD, Krailo MD, Robinson LL. An exploratory analysis of risk factors for childhood malignant germ-cell tumors: report from the Childrens Cancer Group (Canada, United States). Cancer Causes Control 1995; 6: 187–98.

    PubMed  Google Scholar 

  28. RajpertDe Meyts E, Skakkebæk NE. The possible role of sex hormones in the development of testicular cancer. Eur Urol 1993; 23: 54–9.

    PubMed  Google Scholar 

  29. Depue RH, Pike MC, Henderson BE. Estrogen exposure during gestation and risk of testicular cancer. J Natl Cancer Inst 1983; 71: 1151–5.

    PubMed  Google Scholar 

  30. Dorgan JF, Reichman ME, Judd JT, et al. Relationships of age and reproductive characteristics with plasma estrogens and androgens in premenopausal women. Cancer Epidemiol Biomarkers Prev 1995; 4: 381–6.

    PubMed  Google Scholar 

  31. Bernstein L, Pike MC, Ross RK, Judd HL, Brown JB, Henderson BE. Estrogen and sex hormone-binding globulin levels in nulliparous and parous women. JNCI 1985; 74: 741–5.

    PubMed  Google Scholar 

  32. Bernstein L, Depue RH, Ross RK, Judd HL, Pike MC, Henderson BE. Higher maternal levels of free estradiol in first compared to second pregnancy: early gestational differences. J Natl Cancer Inst 1986; 76: 1035–9.

    PubMed  Google Scholar 

  33. Lupulescu A. Estrogen use and cancer risk: a review. Exp Clin Endocrinol 1993; 101: 204–14.

    PubMed  Google Scholar 

  34. Bulmer JN. Immune aspects of pathology of the placental bed contributing to pregnancy pathology. Baillieres Clin Obstet Gynaecol 1992; 6: 461–88.

    PubMed  Google Scholar 

  35. Bach JF. Insulin-dependent diabetes mellitus as an autoimmune disease. Endocr Rev 1994; 15: 516–42.

    Article  PubMed  Google Scholar 

  36. Khong TY, Healy DL, McCloud PI. Pregnancies complicated by abnormally adherent placenta and sex ratio at birth. BMJ 1991; 302: 625–6.

    PubMed  Google Scholar 

  37. Labarrere C, Althabe O. Telenta M. Chronic villitis of unknown aetiology in placentae of idiopathic small-forgestational-age infants. Placenta 1982; 3: 309–18.

    PubMed  Google Scholar 

  38. Labarrere C, Althabe O. Chronic villitis of unknown aetiology in recurrent intrauterine fetal growth retardation. Placenta 1987; 8: 167–73.

    PubMed  Google Scholar 

  39. Intrauterinvæksthæmning og overbåren graviditet. In: Falck Larsen J, Bock JE, Fischer-Rasmussen W, et al. Obstetrik. K¢benhavn: Munksgaard, 1993: 307–315.

  40. Heinzer H, Dieckmann KP, Huland E. Virus-related serology and in situ hybridization for the detection of virus DNA among patients with testicular cancer. Eur Urol 1993; 24: 271–6.

    PubMed  Google Scholar 

  41. RajpertDe Meyts E, Hording U, Nielsen HW, Skakkebæk NE.Human papillomavirus and Epstein-Barr virus in the etiology of testicular germ cell tumours. APMIS 1994; 102: 38–42.

    PubMed  Google Scholar 

  42. Herbst H, Sauter M, Müller Lantzsch N. Expression of human endogenous retrovirus K elements in germ cell and trophoblastic tumors. Am J Pathol 1996; 149: 1727–35.

    PubMed  Google Scholar 

  43. Beck H, Dross A, Mathar W. PCDD and PCDF exposure and levels in humans in Germany. Environ Health Perspect 1994; 102 Suppl 1: 173–85.

    Google Scholar 

  44. Schecter A, Papke O, Lis A, et al. Decrease in milk and blood dioxin levels over two years in a mother nursing twins: estimates of decreased maternal and increased infant dioxin body burden from nursing. Chemosphere 1996; 32: 543–9.

    Article  PubMed  Google Scholar 

  45. M¢ller H, Skakkebæk NE. Risks of testicular cancer and cryptorchidism in relation to socio-economic status and related factors: case-control studies in Denmark. Int J Cancer 1996; 66: 287–93.

    Article  PubMed  Google Scholar 

  46. Chilvers CED, Forman D, Oliver RTD, et al. Social, behavioural and medical factors in the aetiology of testicular cancer: results from the UK study. UK Testicular Cancer Study Group. Br J Cancer 1994; 70: 513–20.

    PubMed  Google Scholar 

  47. BenSasson SA, Davis DL. Neonatal exposure to protoporphyrin-activating lighting as a contributing cause of childhood acute lymphocytic leukemia. Cancer Causes Control 1992; 3: 383–7.

    PubMed  Google Scholar 

  48. Maisels MJ. Jaundice. In: Avery GB, Fletcher MA, Mac-Donald MG, eds. Neonatology: Pathophysiology and management of the Newborn. Philadelphia: JB Lippincott Company, 1994: 630–724.

  49. Davies TW, Williams DR, Whitaker RH. Risk factors for undescended testis. International J Epidemiol 1986; 15: 197–200.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, Norwegian Radium Hospital, Oslo, Norway

    Eva H. Wanderås & Sophie D. Fosså

  2. Cancer Registry of Norway, Oslo, Norway

    Tom Grotmol & Steinar Tretli

Authors
  1. Eva H. Wanderås
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tom Grotmol
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie D. Fosså
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steinar Tretli
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wanderås, E.H., Grotmol, T., Fosså, S.D. et al. Maternal health and pre- and perinatal characteristics in the etiology of testicular cancer: a prospective population- and register-based study on Norwegian males born between 1967 and 1995. Cancer Causes Control 9, 475–486 (1998). https://doi.org/10.1023/A:1008857702380

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008857702380

Search

Navigation