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Pluta J, Pyle LC, Nead KT, Wilf R, Li M, Mitra N, Weathers B, D'Andrea K, Almstrup K, Anson-Cartwright L, Benitez J, Brown CD, Chanock S, Chen C, Cortessis VK, Ferlin A, Foresta C, Gamulin M, Gietema JA, Grasso C, Greene MH, Grotmol T, Hamilton RJ, Haugen TB, Hauser R, Hildebrandt MAT, Johnson ME, Karlsson R, Kiemeney LA, Lessel D, Lothe RA, Loud JT, Loveday C, Martin-Gimeno P, Meijer C, Nsengimana J, Quinn DI, Rafnar T, Ramdas S, Richiardi L, Skotheim RI, Stefansson K, Turnbull C, Vaughn DJ, Wiklund F, Wu X, Yang D, Zheng T, Wells AD, Grant SFA, Rajpert-De Meyts E, Schwartz SM, Bishop DT, McGlynn KA, Kanetsky PA, Nathanson KL. Identification of 22 susceptibility loci associated with testicular germ cell tumors. Nat Commun 2021; 12:4487. [PMID: 34301922 PMCID: PMC8302763 DOI: 10.1038/s41467-021-24334-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
Testicular germ cell tumors (TGCT) are the most common tumor in young white men and have a high heritability. In this study, the international Testicular Cancer Consortium assemble 10,156 and 179,683 men with and without TGCT, respectively, for a genome-wide association study. This meta-analysis identifies 22 TGCT susceptibility loci, bringing the total to 78, which account for 44% of disease heritability. Men with a polygenic risk score (PRS) in the 95th percentile have a 6.8-fold increased risk of TGCT compared to men with median scores. Among men with independent TGCT risk factors such as cryptorchidism, the PRS may guide screening decisions with the goal of reducing treatment-related complications causing long-term morbidity in survivors. These findings emphasize the interconnected nature of two known pathways that promote TGCT susceptibility: male germ cell development within its somatic niche and regulation of chromosomal division and structure, and implicate an additional biological pathway, mRNA translation.
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Affiliation(s)
- John Pluta
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Louise C Pyle
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kevin T Nead
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rona Wilf
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mingyao Li
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nandita Mitra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benita Weathers
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kurt D'Andrea
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristian Almstrup
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
| | - Lynn Anson-Cartwright
- Department of Surgery (Urology), University of Toronto and The Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Javier Benitez
- Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain
| | - Christopher D Brown
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, MD, USA
| | - Chu Chen
- Program in Epidemiology, Fred Hutchinson Cancer Research Center; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Victoria K Cortessis
- Departments of Preventive Medicine and Obstetrics and Gynecology, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Alberto Ferlin
- Unit of Endocrinology and Metabolism, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Marija Gamulin
- Department of Oncology, Division of Medical Oncology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jourik A Gietema
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Grasso
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - Mark H Greene
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, MD, USA
| | - Tom Grotmol
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Robert J Hamilton
- Department of Surgery (Urology), University of Toronto and The Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Trine B Haugen
- Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Russ Hauser
- Department of Environmental Health, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Matthew E Johnson
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ragnhild A Lothe
- Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital-Radiumhospitalet, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jennifer T Loud
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, MD, USA
| | - Chey Loveday
- Division of Genetics & Epidemiology, The Institute of Cancer Research, London, UK
| | | | - Coby Meijer
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jérémie Nsengimana
- Biostatistics Research Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - David I Quinn
- Division of Oncology, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | | | - Shweta Ramdas
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - Rolf I Skotheim
- Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital-Radiumhospitalet, Oslo, Norway
- Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | | | - Clare Turnbull
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- William Harvey Research Institute, Queen Mary University, London, UK
| | - David J Vaughn
- Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Xifeng Wu
- School of Public Health, Zhejiang University, Zhejiang, China
| | - Daphne Yang
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Andrew D Wells
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Struan F A Grant
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Stephen M Schwartz
- Program in Epidemiology, Fred Hutchinson Cancer Research Center; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - D Timothy Bishop
- Department of Haematology and Immunology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, MD, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Katherine L Nathanson
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Zhou J, Xia S, Li T, Liu R. Association between male pattern baldness and testicular germ cell tumor: a meta-analysis. BMC Cancer 2019; 19:53. [PMID: 30634927 PMCID: PMC6329191 DOI: 10.1186/s12885-018-5197-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/09/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The relationship between male pattern baldness and incidence of testicular cancer remains inconclusive. Hence, we performed the present meta-analysis based on all eligible case-control studies. METHODS A comprehensive literature search was performed in July 30th 2018 based on PUBMED, EMBASE and Web of science database. Pooled odds ratio(OR) and its 95% confidence intervals (95% CIs) was calculated with a DerSimonian and Laird random-effects. RESULTS The pooled results were included in this meta-analysis. Overall, We have demonstrated statistically signification between baldness(any pattern) and testicular cancer was identified (OR: 0.61, 95% CI:0.50-0.74). There was no obvious heterogeneity across included studies (P = 0.22 for heterogeneity, I2 = 30%). When subgroup analysis by types of baldness, We found a statistically significant association was observed that baldness(I-VII) might become a protective factor for the risk of testicular germ cell tumor(TGCT). There was no definite connection between alopecia and the different types of TGCT. CONCLUSION Individuals with any pattern baldness may have a decreased risk of testicular cancer, all of analyses studies are warranted to confirm our preliminary findings. According to subgroup analysis of different hair loss grades, we found that 2 stage(II) hair loss can decrease more strongly testicular cancer risk than any other grades. Despite of our findings, We still need further researches to advance knowledge in this field.
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Affiliation(s)
- Jiatong Zhou
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People’s Republic of China
| | - Shuai Xia
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People’s Republic of China
| | - Tao Li
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People’s Republic of China
| | - Ranlu Liu
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People’s Republic of China
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Liang W, Song L, Peng Z, Zou Y, Dai S. Possible association between androgenic alopecia and risk of prostate cancer and testicular germ cell tumor: a systematic review and meta-analysis. BMC Cancer 2018. [PMID: 29529997 PMCID: PMC5848631 DOI: 10.1186/s12885-018-4194-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A number of studies have investigated the association between androgenic alopecia (AGA) and cancer risk, but they have yielded inconsistent results. Therefore, this study was conducted to explore this controversial subject. METHODS A literature database search was performed according to predefined criteria. An odds ratio (OR) or a hazard ratio (HR) with 95% confidence intervals (CIs) was retained to evaluate the relationship between the incidence of cancer or cancer-specific mortality and categories of AGA. Then a pooled OR or HR was derived. RESULTS The pooled results showed that no specific degree of baldness had an influence on the incidence of cancer or cancer-specific mortality. However, AGA, especially frontal baldness, with the incidence of testicular germ cell tumor (TGCT) (OR = 0.69; 95% CI = 0.58-0.83). A significant increase of risk was observed in relation to high grade prostate cancer (PC) (OR = 1.42; 95% CI 1.02-1.99) and vertex with/without frontal baldness was associated with PC risk. CONCLUSIONS The study results supported the hypothesis that AGA is negatively associated with TGCT risk and suggested an overlapping pathophysiological mechanism between them, while the viewpoint that AGA can be used as a phenotypic marker for PC risk was poorly supported.
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Affiliation(s)
- Weijun Liang
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Liuying Song
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Zheng Peng
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Yan Zou
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Shengming Dai
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China.
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Moirano G, Zugna D, Grasso C, Mirabelli D, Lista P, Ciuffreda L, Segnan N, Merletti F, Richiardi L. Postnatal risk factors for testicular cancer: The EPSAM case-control study. Int J Cancer 2017; 141:1803-1810. [PMID: 28699204 DOI: 10.1002/ijc.30884] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/23/2017] [Accepted: 06/21/2017] [Indexed: 11/11/2022]
Abstract
Testicular cancer is considered to originate from an impaired differentiation of fetal germ cells, but puberty could represent another time window of susceptibility. Our study aimed at investigating the association between environmental exposures acting during puberty/adolescence (13-19 years of age) and the risk of testicular cancer. We used data of the EPSAM study, a case-control study on germ-cell testicular cancer conducted in the province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Histologically confirmed cases (n = 255) and controls (n = 459) completed a postal questionnaire focusing in particular on the pubertal period (namely age 13 years) with questions on physical activity (competitive sports, gardening), lifestyle (alcohol consumption, smoking), occupational history and medical conditions. All analyses were adjusted for the matching variables, cryptorchidism and educational level. Having done at least one competitive sport during puberty (odds ratio [OR]: 0.72, 95% confidence interval: 0.52-1.00), gardening activities during puberty (OR: 0.62, 0.42-0.94) and having a lower weight than peers during puberty (OR: 0.64, 0.42-0.97) were all inversely associated with the risk of testicular cancer. No evidence of association between smoking or alcohol consumption during puberty and the risk of testicular cancer was observed. Regarding agriculture-related occupations, we found an association with the risk of testicular cancer both for occasional jobs during puberty (OR: 2.40, 95% CI: 1.08-5.29) and ever employment in adolescence (OR: 2.59, 95% CI: 0.83-8.10). Our results suggest that postnatal exposures could play a role in testicular cancer aetiology, at least when acting in puberty or adolescence.
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Affiliation(s)
- Giovenale Moirano
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Daniela Zugna
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Chiara Grasso
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Dario Mirabelli
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Patrizia Lista
- Medical Oncology Division 1, University Hospital "Citta' della Salute e della Scienza", Turin, Italy
| | - Libero Ciuffreda
- Medical Oncology Division 1, University Hospital "Citta' della Salute e della Scienza", Turin, Italy
| | - Nereo Segnan
- Department of Cancer Screening and Unit of Cancer Epidemiology, WHO Collaborative Center for Cancer Early Diagnosis and Screening, CPO Piedmont and University Hospital "Citta' della Salute e della Scienza", Turin, Italy
| | - Franco Merletti
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
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Grasso C, Zugna D, Fiano V, Robles Rodriguez N, Maule M, Gillio-Tos A, Ciuffreda L, Lista P, Segnan N, Merletti F, Richiardi L. Subfertility and Risk of Testicular Cancer in the EPSAM Case-Control Study. PLoS One 2016; 11:e0169174. [PMID: 28036409 PMCID: PMC5201268 DOI: 10.1371/journal.pone.0169174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/13/2016] [Indexed: 11/19/2022] Open
Abstract
Background/objectives It has been suggested that subfertility and testicular cancer share genetic and environmental risk factors. We studied both subfertility and the strongest known testicular cancer susceptibility gene, the c-KIT ligand (KITLG), whose pathway is involved in spermatogenesis. Methods The EPSAM case-control study is comprised of testicular cancer patients from the Province of Turin, Italy, diagnosed between 1997 and 2008. The present analysis included 245 cases and 436 controls from EPSAM, who were aged 20 years or older at diagnosis/recruitment. The EPSAM questionnaire collected information on factors such as number of children, age at first attempt to conceive, duration of attempt to conceive, use of assisted reproduction techniques, physician-assigned diagnosis of infertility, number of siblings, and self-reported cryptorchidism. Genotyping of the KITLG single nucleotide polymorphism (SNP) rs995030 was performed on the saliva samples of 202 cases and 329 controls. Results Testicular cancer was associated with the number of children fathered 5 years before diagnosis (odds ratio (OR) per additional child: 0.78, 95% confidence interval (CI): 0.58–1.04) and sibship size (OR per additional sibling: 0.76, 95% CI: 0.66–0.88). When considering the reproductive history until 1 year before diagnosis, attempting to conceive for at least 12 months or fathering a child using assisted reproduction techniques was not associated with the risk of testicular cancer, nor was age at first attempt to conceive or physician-assigned diagnosis of infertility. The SNP rs995030 was strongly associated with risk of testicular cancer (per allele OR: 1.83; 95%CI: 1.26–2.64), but it did not modify the association between number of children and the risk of testicular cancer. Conclusion This study supports the repeatedly reported inverse association between number of children and risk of testicular cancer, but it does not find evidence of an association for other indicators of subfertility.
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Affiliation(s)
- Chiara Grasso
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
- * E-mail:
| | - Daniela Zugna
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Valentina Fiano
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Nena Robles Rodriguez
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Milena Maule
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Anna Gillio-Tos
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Libero Ciuffreda
- Medical Oncology Division 1, University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Patrizia Lista
- Medical Oncology Division 1, University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Nereo Segnan
- Department of Cancer Screening and Unit of Cancer Epidemiology, WHO Collaborative Center for Cancer Early Diagnosis and Screening, CPO Piedmont and University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Franco Merletti
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit-CeRMS, Department of Medical Sciences, University of Turin and CPO Piedmont, Turin, Italy
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