Pre-natal and peri-natal exposures and risk of testicular germ-cell cancer

The present case-control study was undertaken to investigate the associatio n between exposure to maternal hormones and risk of testicular germ-cell ca ncer by histologic subgroups. Cases were males, aged 16 to 59 years, diagno sed with testicular germ-cell cancer in Ontario between 1987 and 1989. Hist ologic review was performed on all eligible cases for the purpose of catego rizing cases as seminoma or nonseminoma (the latter classified 2 ways, with and without tumors containing seminoma), Risk factor data were collected o n 502 cases, 346 case mothers, 975 age-matched controls, and 522 control mo thers. Exogenous hormone exposure was associated with elevated risk (OR = 4 .9, 95% CI 1.7-13.9). Several additional risk factors were associated with risk of testicular cancer: bleeding and threatened miscarriage (OR = 0.6, 9 5% CI 0.3-1.0), maternal cigarette smoking (12+ cigarettes/day OR = 0.6, 95 % CI 0.4-1.0). pre-term birth (OR = 1.6, 95% CI 1.0-2.5), and treatment for undescended testicle (OR = 8.0, 95% CI 3.2-20.0). First births were associ ated with elevated risk (OR = 1.7, 95% CI 1.0-2.8) among mothers below the age of 24 years at conception. There was little evidence that risk factors differed by histologic subgroup. We found evidence that exposure to materna l hormones, particularly estrogens, is associated with testicular germ-cell cancer risk. Not only does exposure to elevated levels (exogenous hormone use, pre-term birth, and first births among young mothers) increase risk bu t also exposure to relatively lower levels (heavy cigarette consumption and , perhaps, bleeding and threatened miscarriage) may decrease cancer risk, I nt. J. Cancer 87:438-443, 2000. (C) 2000 Wiley-Liss, Inc.