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

Objectives: The aim of the present prospective study was to identify possib le risk factors of testicular cancer (TC) in relation to gestation and birt h. Methods: Based on data from compulsory birth and cancer registration in Nor way, odds ratios (ORs) of TC were estimated. Results: Among 868 068 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 te ndency of an inverse association between parity and TC. A previous finding from Sweden linking neonatal jaundice to risk of non-seminomas was confirme d (adjusted OR = 2.1, 95 percent confidence interval [CI] = 1.3-6.9). Signi ficant associations were also seen for seminomas and TC diagnosed after 5 y ears 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 bo th seminomas and non-seminomas and with TC diagnosed after 5 years of age. Conclusions: The findings of this study support the existing hypothesis tha t 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 f actors, supported by the association of parity to TC, Additionally, on the basis of findings in maternal diseases and complications to pregnancy, we s uggest that immune reactions during foetal life may be of significance for development of TC.