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Yazici S, Del Biondo D, Napodano G, Grillo M, Calace FP, Prezioso D, Crocetto F, Barone B. Risk Factors for Testicular Cancer: Environment, Genes and Infections-Is It All? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040724. [PMID: 37109682 PMCID: PMC10145700 DOI: 10.3390/medicina59040724] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/11/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023]
Abstract
The incidence of testicular cancer is steadily increasing over the past several decades in different developed countries. If on one side better diagnosis and treatment have shone a light on this disease, on the other side, differently from other malignant diseases, few risk factors have been identified. The reasons for the increase in testicular cancer are however unknown while risk factors are still poorly understood. Several studies have suggested that exposure to various factors in adolescence as well as in adulthood could be linked to the development of testicular cancer. Nevertheless, the role of environment, infections, and occupational exposure are undoubtedly associated with an increase or a decrease in this risk. The aim of this narrative review is to summarize the most recent evidence regarding the risk factors associated with testicular cancer, starting from the most commonly evaluated (cryptorchidism, family history, infections) to the newer identified and hypothesized risk factors.
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Affiliation(s)
- Sertac Yazici
- Department of Urology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
| | - Dario Del Biondo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Giorgio Napodano
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Marco Grillo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
- University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Paolo Calace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Domenico Prezioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
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Li Y, Lu Q, Wang Y, Ma S. Racial differences in testicular cancer in the United States: descriptive epidemiology. BMC Cancer 2020; 20:284. [PMID: 32252689 PMCID: PMC7137202 DOI: 10.1186/s12885-020-06789-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Testicular cancer (TC) is the most common malignancy in young adult men, and in many countries the incidence rates of testicular cancer have been increasing since the middle of the twentieth century. Since disease presentation and tumor progression patterns are often heterogeneous across racial groups, there may be important racial differences in recent TC trends. METHODS In this study, Surveillance, Epidemiology, and End Results (SEER) data on TC patients diagnosed between 1973 and 2015 were analyzed, including the following racial/ethnic groups: non-Hispanic whites (NHW), Hispanic whites (HW), blacks, and Asians and Pacific Islanders (API). Patient characteristics, age-adjusted incidence rates, and survival were compared across racial groups. A multivariate Cox model was used to analyze the survival data of TC patients, in order to evaluate racial differences across several relevant factors, including marital status, age group, histologic type, treatment, stage, and tumor location. RESULTS NHWs had the highest incidence rates, followed by blacks, HWs, and APIs. There were significant survival differences among the racial groups, with NHWs having the highest survival rates and blacks having the lowest. CONCLUSION An analysis of SEER data showed that racial differences existed among TC patients in the United States with respect to patient characteristics, incidence, and survival. The results can be useful to stakeholders interested in reducing the burden of TC morbidity and mortality.
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Affiliation(s)
- Yang Li
- Center for Applied Statistics, Renmin University of China, Beijing, China
- School of Statistics, Renmin University of China, Beijing, China
| | - Qi Lu
- School of Statistics, Renmin University of China, Beijing, China
| | - Yu Wang
- Center for Applied Statistics, Renmin University of China, Beijing, China.
- School of Statistics, Renmin University of China, Beijing, China.
| | - Shuangge Ma
- School of Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven, Connecticut, USA
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Signal V, Huang S, Sarfati D, Stanley J, McGlynn KA, Gurney JK. Dairy Consumption and Risk of Testicular Cancer: A Systematic Review. Nutr Cancer 2018; 70:710-736. [PMID: 29781734 DOI: 10.1080/01635581.2018.1470655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Dairy consumption has been studied extensively in terms of its relationship with testicular cancer (TC), yet this relationship remains unclear. In this systematic review, we aimed to answer whether TC development is associated with (a) high amounts of dairy product consumption, (b) the type of dairy product consumed, (c) increasing levels of dairy product consumption, and (d) dairy consumption during certain periods during the lifecourse. Following a systematic review of the literature, eight studies (all case-control studies) were included in our review. The included studies varied in terms of the dairy product(s) investigated (milk, cheese, cream, butter, and yoghurt) as well as the type of exposure to dairy consumption (e.g., high vs. low exposure, dose-response, and timing during lifecourse). We found that there was no strong evidence that high levels of dairy consumption are associated with risk of TC, conflicting evidence of a dose-response relationship, inconsistent evidence on whether certain types of dairy are more strongly associated with TC than others, and conflicting evidence that exposure during certain life-course periods affects TC risk more than other periods. There is no consistent evidence to support the premise that dairy product consumption is associated with the risk of TC development.
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Affiliation(s)
- Virginia Signal
- a Cancer and Chronic Conditions (C3) Research Group , Department of Public Health, University of Otago , Wellington , New Zealand
| | - Stephanie Huang
- a Cancer and Chronic Conditions (C3) Research Group , Department of Public Health, University of Otago , Wellington , New Zealand
| | - Diana Sarfati
- a Cancer and Chronic Conditions (C3) Research Group , Department of Public Health, University of Otago , Wellington , New Zealand
| | - James Stanley
- a Cancer and Chronic Conditions (C3) Research Group , Department of Public Health, University of Otago , Wellington , New Zealand
| | - Katherine A McGlynn
- b Division of Cancer Epidemiology & Genetics, National Cancer Institute , Rockville , Maryland , USA
| | - Jason K Gurney
- a Cancer and Chronic Conditions (C3) Research Group , Department of Public Health, University of Otago , Wellington , New Zealand
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Boccellino M, Vanacore D, Zappavigna S, Cavaliere C, Rossetti S, D'Aniello C, Chieffi P, Amler E, Buonerba C, Di Lorenzo G, Di Franco R, Izzo A, Piscitelli R, Iovane G, Muto P, Botti G, Perdonà S, Caraglia M, Facchini G. Testicular cancer from diagnosis to epigenetic factors. Oncotarget 2017; 8:104654-104663. [PMID: 29262668 PMCID: PMC5732834 DOI: 10.18632/oncotarget.20992] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/29/2017] [Indexed: 12/16/2022] Open
Abstract
Testicular cancer (TC) is one of the most common neoplasms that occurs in male and includes germ cell tumors (GCT), sex cord-gonadal stromal tumors and secondary testicular tumors. Diagnosis of TC involves the evaluation of serum tumor markers alpha-fetoprotein, human chorionic gonadotropin and lactate dehydrogenase, but clinically several types of immunohistochemical markers are more useful and more sensitive in GCT, but not in teratoma. These new biomarkers are genes expressed in primordial germ cells/gonocytes and embryonic pluripotency-related cells but not in normal adult germ cells and they include PLAP, OCT3/4 (POU5F1), NANOG, SOX2, REX1, AP-2γ (TFAP2C) and LIN28. Gene expression in GCT is regulated, at least in part, by DNA and histone modifications, and the epigenetic profile of these tumours is characterised by genome-wide demethylation. There are different epigenetic modifications in TG-subtypes that reflect the normal developmental switch in primordial germ cells from an under- to normally methylated genome. The main purpose of this review is to illustrate the findings of recent investigations in the classification of male genital organs, the discoveries in the use of prognostic and diagnostic markers and the epigenetic aberrations mainly affecting the patterns of DNA methylation/histone modifications of genes (especially tumor suppressors) and microRNAs (miRNAs).
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Affiliation(s)
- Mariarosaria Boccellino
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Naples, Italy
| | - Daniela Vanacore
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Naples, Italy.,Progetto ONCONET 2.0, Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo, Regione Campania, Italy
| | - Silvia Zappavigna
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Naples, Italy
| | - Carla Cavaliere
- Medical Oncology Unit, ASL NA 3 SUD, Ospedali Riuniti Area Nolana, Nola, Italy
| | - Sabrina Rossetti
- Progetto ONCONET 2.0, Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo, Regione Campania, Italy.,Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
| | - Carmine D'Aniello
- Division of Medical Oncology, A.O.R.N. dei COLLI "Ospedali Monaldi-Cotugno-CTO", Napoli, Italy
| | - Paolo Chieffi
- Department of Psychology, University of Campania "L. Vanvitelli" Naples, Naples, Italy
| | - Evzen Amler
- 2nd Faculty of Medicine, Charles University, V Uvalu 84, Prague 5, Czech Republic.,Faculty of Biomedical Engineering, UCEEB, CVUT, Zikova 4, Prague 6, Student Science, H.Podluzi, Prague, Czech Republic
| | - Carlo Buonerba
- Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Rossella Di Franco
- Progetto ONCONET 2.0, Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo, Regione Campania, Italy.,Radiation Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale'-IRCCS, Napoli, Italy
| | - Alessandro Izzo
- Division of Urology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
| | - Raffaele Piscitelli
- Progetto ONCONET 2.0, Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo, Regione Campania, Italy
| | - Gelsomina Iovane
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
| | - Paolo Muto
- Radiation Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale'-IRCCS, Napoli, Italy
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale"- IRCCS, Naples, Italy.,Scientific Management, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
| | - Sisto Perdonà
- Division of Urology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Naples, Italy
| | - Gaetano Facchini
- Progetto ONCONET 2.0, Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo, Regione Campania, Italy.,Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori 'Fondazione G. Pascale'-IRCCS, Naples, Italy
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Recent advances in molecular and cell biology of testicular germ-cell tumors. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2014; 312:79-100. [PMID: 25262239 DOI: 10.1016/b978-0-12-800178-3.00003-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Testicular germ-cell tumors (TGCTs) are the most frequent solid malignant tumors in men 20-40 years of age and the most frequent cause of death from solid tumors in this age group. TGCTs comprise two major histologic groups: seminomas and nonseminomas germ-cell tumors (NSGCTs). NSGCTs can be further divided into embryonal, carcinoma, Teratoma, yolk sac tumor, and choriocarcinoma. Seminomas and NSGCTs present significant differences in clinical features, therapy, and prognosis, and both show characteristics of the primordial germ cells. Many discovered biomarkers including OCT3/4, SOX2, SOX17, HMGA1, Nek2, GPR30, Aurora-B, estrogen receptor β, and others have given further advantages to discriminate between histological subgroups and could represent useful novel molecular targets for antineoplastic strategies. More insight into the pathogenesis of TGCTs is likely to improve disease management not only to better treatment of these tumors but also to a better understanding of stem cells and oncogenesis.
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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.
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Affiliation(s)
- Katherine A McGlynn
- Division of Hormonal and Reproductive Epidemiology, National Cancer Institute, Suite 550 6120 Executive Boulevard, Rockville, MD 20852, USA.
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Banks K, Tuazon E, Berhane K, Koh CJ, De Filippo RE, Chang A, Kim SS, Daneshmand S, Davis-Dao C, Lewinger JP, Bernstein L, Cortessis VK. Cryptorchidism and testicular germ cell tumors: comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics. Front Endocrinol (Lausanne) 2012; 3:182. [PMID: 23423470 PMCID: PMC3574983 DOI: 10.3389/fendo.2012.00182] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 12/20/2012] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Risk of testicular germ cell tumors (TGCT) is consistently associated with a history of cryptorchidism (CO) in epidemiologic studies. Factors modifying the association may provide insights regarding etiology of TGCT and suggest a basis for individualized care of CO. To identify modifiers of the CO-TGCT association, we conducted a comprehensive, quantitative evaluation of epidemiologic data. MATERIALS AND METHODS Human studies cited in PubMed or ISI Web of Science indices through December 2011 and selected unpublished epidemiologic data were reviewed to identify 35 articles and one unpublished dataset with high-quality data on the CO-TGCT association. Association data were extracted as point and 95% confidence interval estimates of odds ratio (OR) or standardized incidence ratio (SIR), or as tabulated data. Values were recorded for each study population, and for subgroups defined by features of study design, CO and TGCT. Extracted data were used to estimate summary risk ratios (sRR) and evaluate heterogeneity of the CO-TGCT association between subgroups. RESULTS The overall meta-analysis showed that history of CO is associated with four-fold increased TGCT risk [RR = 4.1(95% CI = 3.6-4.7)]. Subgroup analyses identified five determinants of stronger association: bilateral CO, unilateral CO ipsilateral to TGCT, delayed CO treatment, TGCT diagnosed before 1970, and seminoma histology. CONCLUSIONS Modifying factors may provide insight into TGCT etiology and suggest improved approaches to managing CO. Based on available data, CO patients and their parents or caregivers should be made aware of elevated TGCT risk following orchidopexy, regardless of age at repair, unilateral vs. bilateral non-descent, or position of undescended testes.
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Affiliation(s)
- Kimberly Banks
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- City of Hope National Medical CenterDuarte, CA, USA
- St. Joseph HospitalOrange, CA, USA
| | - Ellenie Tuazon
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Kiros Berhane
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Chester J. Koh
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Roger E. De Filippo
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Andy Chang
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Steve S. Kim
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Siamak Daneshmand
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Carol Davis-Dao
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Juan P. Lewinger
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Leslie Bernstein
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- City of Hope National Medical CenterDuarte, CA, USA
| | - Victoria K. Cortessis
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- *Correspondence: Victoria K. Cortessis, Department of Preventive Medicine, University of Southern California, 1441 Eastlake Avenue, MC-9175, Los Angeles, CA 90089-9175, USA. e-mail:
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Stang A, Kuss O. Etiologic Differences Between Seminoma and Nonseminoma of the Testis: A Systematic Review of Epidemiologic Studies. Hematol Oncol Clin North Am 2011; 25:473-86, vii. [DOI: 10.1016/j.hoc.2011.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brunetti L, Leone S, Chiavaroli A, Orlando G, Recinella L, Ferrante C, Di Nisio C, Verratti V, Vacca M. Cafeteria diet increases prostaglandin E2 levels in rat prostate, kidney and testis. Int J Immunopathol Pharmacol 2011; 23:1073-8. [PMID: 21244756 DOI: 10.1177/039463201002300411] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nutrient composition, particularly the omega-6/omega-3 polyunsaturated fatty acids ratio, may differently affect inflammatory mediators production in tissues, which could be causally related to increased cancer incidence in obesity. We evaluated prostaglandin E(2) levels in male Wistar rat prostate, kidney and testicle tissues after 15 days of either a high fat, cafeteria-style diet (5.50 Kcal/g, 30 percent calories from fat, omega-6/omega-3 ratio 2.33) or a standard laboratory chow diet (3.35 Kcal/g, 3 percent calories from fat, omega-6/omega-3 ratio 0.56). In the cafeteria diet compared to standard laboratory diet rats, we found both an increase in weight gain and increased prostaglandin E(2) (PGE(2)) levels in prostate, kidney and testicle tissues. The increased levels of PGE(2) induced by the cafeteria diet could drive an inflammatory process leading to increased incidence of prostate, kidney and testicular cancer in overweight patients.
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Affiliation(s)
- L Brunetti
- Department of Drug Sciences, "G. d'Annunzio" University, Chieti, Italy
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Lerro CC, McGlynn KA, Cook MB. A systematic review and meta-analysis of the relationship between body size and testicular cancer. Br J Cancer 2010; 103:1467-74. [PMID: 20978513 PMCID: PMC2990613 DOI: 10.1038/sj.bjc.6605934] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Studies assessing the relationships of anthropometry and testicular germ-cell tumour (TGCT) have reported heterogeneous findings. Methods: We undertook a systematic review and meta-analysis of the associations between adult height, weight, body mass index (BMI), and testicular cancer. Search strategies were conducted in PubMed, EMBASE, Scopus, and Web of Science on 26 May 2009. Studies that met our inclusion criteria were included in meta-analytic models using STATA 11. Results: A total of 3255 references were retrieved, of which 14 met the inclusion criteria. Random effects meta-analysis found adult height (odds ratio (OR) per 5-cm increase 1.13, 95% confidence interval (CI) 1.07–1.19, P<0.001) and weight (OR overweight vs normal 0.92, 95% CI 0.86–0.98, P=0.011) to be associated with TGCT. The meta-analysis of weight and TGCT produced a summary estimate, which indicated no association, although an analysis restricted studies to North American was suggestive of association (OR per 1-kg increase 1.01, 95% CI 1.00–1.01, P<0.001). Conclusions: This systematic review and meta-analysis has found evidence for a positive association of adult height and TGCT, and tentative evidence for an inverse association of BMI and TGCT.
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Affiliation(s)
- C C Lerro
- Yale School of Public Health, Yale University, New Haven, CT, USA
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Cook MB, Akre O, Forman D, Madigan MP, Richiardi L, McGlynn KA. A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer--experiences of the son. Int J Epidemiol 2010; 39:1605-18. [PMID: 20660640 DOI: 10.1093/ije/dyq120] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We undertook a systematic review and meta-analysis of perinatal variables in relation to testicular cancer risk, with a specific focus upon characteristics of the son. METHODS Literature databases Scopus, EMBASE, PubMed and Web of Science were searched using highly sensitive search strategies. Of 5865 references retrieved, 67 articles met the inclusion criteria, each of which was included in at least one perinatal analysis. RESULTS Random effects meta-analysis produced the following results for association with testicular cancer risk: birth weight [per kilogram, odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.88-1.01, I(2)= 12%], low birth weight (OR = 1.34, 95% CI 1.08-1.67, I(2)= 51%), high birth weight (OR = 1.05, 95% CI 0.96-1.14, I(2)= 0%), gestational age (per week, OR = 0.95, 95% CI 0.92-0.98, I(2)= 38%; low vs not, OR = 1.31, 95% CI 1.07-1.59, I(2)= 49%), cryptorchidism (OR = 4.30, 95% CI 3.62-5.11, I(2)= 44%), inguinal hernia (OR = 1.63, 95% CI 1.37-1.94, I(2)= 38%) and twinning (OR = 1.22, 95% CI 1.03-1.44, I(2)= 22%). Meta-analyses of the variables birth length, breastfeeding and neonatal jaundice did not provide evidence for an association with testicular cancer risk. When low birth weight was stratified by data ascertainment (record/registry vs self-report), only the category of self-report was indicative of an association. Meta-regression of data ascertainment (record/registry vs self-report) inferred that record-/registry-based studies were less supportive of an association with gestational age (per week = 0.97, 95% CI 0.94-1.00, I(2)( )= 29%; low vs not = 1.08, 95% CI 0.91-1.28, I(2)= 32%). CONCLUSION In conclusion, this systematic review and meta-analysis finds evidence that cryptorchidism, inguinal hernia and twinning, and tentative evidence that birth weight and gestational age, are associated with risk of testicular cancer.
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Affiliation(s)
- Michael B Cook
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20852-7234, USA.
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Mafra ACCN, Nucci LB, Cordeiro R, Stephan C. Estudo caso-controle com resposta multinomial: uma proposta de análise. CAD SAUDE PUBLICA 2010; 26:451-9. [DOI: 10.1590/s0102-311x2010000300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 10/16/2009] [Indexed: 11/21/2022] Open
Abstract
Este estudo revisa alguns artigos com delineamento do tipo caso-controle em que se tem os casos classificados em dois ou mais tipos. A aplicação de modelos para respostas multinomiais e a adequabilidade destes aos estudos caso-controle é discutida. Dentre os ajustes possíveis, argumenta-se que o modelo logístico Politômico é o mais indicado para a obtenção de medidas epidemiológicas de risco e associação neste tipo de delineamento. Como ilustração, apresenta-se uma aplicação desse modelo em um estudo caso-controle de base populacional, comparando os resultados com aqueles obtidos em um ajuste logístico binomial. A abordagem multinomial possibilita investigar, em uma única análise, a ocorrência de associações entre co-variáveis e uma ou algumas das classes de casos estudados, abrindo a possibilidade, de grande interesse epidemiológico, de identificação de fatores de risco e de proteção individualizados para cada subgrupo de interesse.
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Chieffi P, Franco R, Portella G. Molecular and cell biology of testicular germ cell tumors. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2009; 278:277-308. [PMID: 19815181 DOI: 10.1016/s1937-6448(09)78006-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although testicular germ cell tumors (TGCTs) are relatively uncommon, they are particularly important as they tend to affect children and young men, representing the most common tumor in male aged from 20 to 40years. TGCTs are a heterogeneous group of tumors, with specific peculiarities reflecting on epidemiologic distribution and clinic-pathological features. TGCTs show a high-cure rates in both seminomas and nonseminomas and represent the model of a curable neoplasia: sensitive serum tumor markers, accurate prognostic classification, contribute to a high effectiveness of cancer therapy. However, up to 30% of patients diagnosed with metastatic nonseminomas do not achieve a durable remission, and in metastatic teratomas cisplatin-based treatment resistance has been observed. These different prognostic and therapeutic features of TGCTs highlight the need for a better understanding of the molecular biology of TGCT, that could help to improve disease management and to tailor aggressiveness of treatment to the severity of the prognosis.
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Affiliation(s)
- Paolo Chieffi
- Dipartimento di Medicina Sperimentale, II Università di Napoli, 80138 Naples, Italy
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15
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Hu J, La Vecchia C, DesMeules M, Negri E, Mery L. Meat and fish consumption and cancer in Canada. Nutr Cancer 2008; 60:313-24. [PMID: 18444165 DOI: 10.1080/01635580701759724] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this study, we examined the association between meat and fish intake and the risk of various cancers. Mailed questionnaires were completed by 19,732 incident, histologically confirmed cases of cancer of the stomach, colon, rectum, pancreas, lung, breast, ovary, prostate, testis, kidney, bladder, brain, non-Hodgkin's lymphomas (NHL), and leukemia and 5,039 population controls between 1994 and 1997 in 8 Canadian provinces. Measurement included information on socioeconomic status, lifestyle habits, and diet. A 69-item food frequency questionnaire provided data on eating habits 2 yr before data collection. Odds ratios and 95% confidence intervals were derived through unconditional logistic regression. Total meat and processed meat were directly related to the risk of stomach, colon, rectum, pancreas, lung, breast (mainly postmenopausal), prostate, testis, kidney, bladder, and leukemia. Red meat was significantly associated with colon, lung (mainly in men), and bladder cancer. No relation was observed for cancer of the ovary, brain, and NHL. No consistent excess risk emerged for fish and poultry, which were inversely related to the risk of a number of cancer sites. These findings add further evidence that meat, specifically red and processed meat, plays an unfavorable role in the risk of several cancers. Fish and poultry appear to be favorable diet indicators.
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Affiliation(s)
- Jinfu Hu
- Evidence and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada.
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16
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Dieckmann KP, Hartmann JT, Classen J, Lüdde R, Diederichs M, Pichlmeier U. Tallness is associated with risk of testicular cancer: evidence for the nutrition hypothesis. Br J Cancer 2008; 99:1517-21. [PMID: 18827809 PMCID: PMC2579680 DOI: 10.1038/sj.bjc.6604695] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The pathogenesis of testicular germ cell tumours (GCTs) is potentially influenced by high-energy nutrition during infancy. As adult height is a proxy for childhood nutrition, we investigated the role of nutrition in GCT pathogenesis by comparing stature of patients with healthy men. In a matched case–control study, 6415 patients with GCT were compared with healthy army conscripts (1:6 matching modus) with regard to height (cm) and body mass index (BMI; kg/m2). Statistical analysis involved tabulation of descriptive height measures and BMI. Conditional logistic regression models were used to quantify the association of GCT with height, with odds ratios (OR) adjusted for BMI. The literature was searched for studies on stature in GCT patients. Body size is significantly associated with risk of GCT, very tall men (>195 cm) having a GCT risk of OR=3.35 (95% confidence intervals (CI): 2.88–3.90; adjusted). Short stature is protective (OR=0.798; 95% CI: 0.68–0.93). Both histologic subgroups are associated with tallness. Of 16 previous reports, 7 were confirmative, 5 had null and 4 equivocal results. The association of stature with GCT risk accords with the nutrition hypothesis of GCT. This study expands the current view of GCT tumorigenesis by suggesting that high-calorie intake in childhood promotes GCT precursors originating in utero.
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Affiliation(s)
- K-P Dieckmann
- Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Hamburg, Germany.
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McIntyre A, Gilbert D, Goddard N, Looijenga L, Shipley J. Genes, chromosomes and the development of testicular germ cell tumors of adolescents and adults. Genes Chromosomes Cancer 2008; 47:547-57. [PMID: 18381640 DOI: 10.1002/gcc.20562] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Testicular germ cell tumors (TGCTs) of adults and adolescents are thought to be derived from primordial germ cells or gonocytes. TGCTs develop postpuberty from precursor lesions known as intratubular germ cell neoplasia undifferentiated. The tumors can be divided into two groups based on their histology and clinical behavior; seminomas resemble primordial germ cells or gonocytes and nonseminomas resemble embryonic or extraembryonic tissues at various stages of differentiation. The most undifferentiated form of nonseminoma, embryonal carcinoma, resembles embryonic stem cells in terms of morphology and expression profiling, both mRNAs and microRNAs. Evidence supports both environmental factors and genetic predisposition underlying the development of TGCTs. Various models of development have been proposed and are discussed. In TGCTs, gain of material from the short arm of chromosome 12 is invariable: genes from this region include the proto-oncogene KRAS, which has activating mutations in approximately 10% of tumors or is frequently overexpressed. A number of different approaches to increase the understanding of the development and progression of TGCTs have highlighted the involvement of KIT, RAS/RAF/MAPK, STAT, and PI3K/AKT signaling. We review the role of these signaling pathways in this process and the potential influence of environmental factors in the development of TGCTs.
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Affiliation(s)
- Alan McIntyre
- Molecular Cytogenetics, Section of Molecular Carcinogenesis, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
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18
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Ghosh C, Baker JA, Moysich KB, Rivera R, Brasure JR, McCann SE. Dietary Intakes of Selected Nutrients and Food Groups and Risk of Cervical Cancer. Nutr Cancer 2008; 60:331-41. [DOI: 10.1080/01635580701861769] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Chaitali Ghosh
- a Department of Mathematics , State University of New York College at Buffalo , Buffalo, New York, USA
| | - Julie A. Baker
- b School of Medicine and Biomedical Sciences , State University of New York at Buffalo , Buffalo, New York, USA
- c Department of Epidemiology, Division of Cancer Prevention and Population Sciences , Roswell Park Cancer Institute , Buffalo, New York, USA
| | - Kirsten B. Moysich
- c Department of Epidemiology, Division of Cancer Prevention and Population Sciences , Roswell Park Cancer Institute , Buffalo, New York, USA
| | - Ruqayyah Rivera
- d Ronald Erwin McNair Post-Baccalaureate Achievement Program, State University of New York College at Buffalo , Buffalo, New York, USA
| | - John R. Brasure
- e Department of Social and Preventive Medicine, School of Public Health and Health Professions , State University of New York at Buffalo , Buffalo, New York, USA
| | - Susan E. McCann
- c Department of Epidemiology, Division of Cancer Prevention and Population Sciences , Roswell Park Cancer Institute , Buffalo, New York, USA
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19
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Perry Glauert H. Influence of Dietary Fat on the Development of Cancer. FOOD SCIENCE AND TECHNOLOGY 2008. [DOI: 10.1201/9781420046649.ch25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Chang SS, Ivey B, Smith JA, Roth BJ, Cookson MS. Performance-enhancing supplement use in patients with testicular cancer. Urology 2005; 66:242-5. [PMID: 16098349 DOI: 10.1016/j.urology.2005.04.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2005] [Revised: 04/16/2005] [Accepted: 04/29/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify supplement use among patients diagnosed with testicular cancer. The incidence of testicular cancer has increased, as has supplement use, including those designed specifically for exercise performance enhancement. METHODS A questionnaire was administered to patients with testicular germ cell cancer treated at our institution between 1990 and 2004. This survey addressed the use of supplements before, during, and after the diagnosis of cancer. RESULTS Of the 129 patients who completed the questionnaire, 26 (20.1%) used some form of supplements, most of which were ingested for exercise performance enhancement. The most common supplement taken was protein/amino acids (12.4%) followed by creatine (9.3%) and androstenedione (1.6%). The mean duration of supplement use was 17.0 months. The mean age of the patients who had used supplements was 27.6 years (median 26, range 17 to 47) compared with 35.7 years (median 34, range 14 to 76) for patients who had not used supplements. Of the 57 patients diagnosed before 2000, 9 (16%) reported supplement use and 3 (5%) reported creatine use. Of the 72 patients diagnosed during or after 2000, 17 (24%) reported supplement use and 9 (13%) reported creatine use. CONCLUSIONS Supplement use is common and increasing among patients with testicular cancer. The use of exercise performance-enhancing supplements was as great as 20%. Given the increasing incidence of testicular cancer, coupled with the widespread use of these performance-enhancing supplements in this at-risk group, additional study is required to determine what association, if any, exists between the use of these substances and the development of testicular cancer.
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Affiliation(s)
- Sam S Chang
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765, USA.
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21
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Hoffmann K, Blaudszun J, Brunken C, Tauber R, Höpker WW, Steinhart H. Distribution of conjugated linoleic acid in total and subcellular fractions from normal and cancerous parts of human testes. Mol Nutr Food Res 2005; 49:756-62. [PMID: 15995985 DOI: 10.1002/mnfr.200500054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective of the present study was to examine differences in the fatty acid composition of subcellular fractions from normal and cancerous parts of human testes. The conjugated linoleic acid (CLA) content was significantly higher in total testicular carcinoma (TC), but significantly lower in the mitochondrial fraction of TC in comparison to normal testicular tissue. The subcellular distribution pattern of CLA was similar to that of monounsaturated fatty acids, but different to that of 18:2n-6 (linoleic acid), underlining the different physiological properties of CLA and 18 : 2n-6. Because polyunsaturated fatty acids (PUFAs) have been suggested to have an effect on cancer risk and previous research has found that CLA inhibits the metabolism of 18 : 2n-6 into 20 : 4n-6, the contents of n-6 and n-3 PUFAs were determined. Significant differences were observed for 18 : 2n-6, 18 : 3n-3, 20 : 5n-3, and 22 : 6n-3, with 18 : 2n-6, 18 : 3n-3, and 20 : 5n-3 contents being higher and 22 : 6n-3 content being lower in TC than in normal testicular tissue. These results indicate a changed availability of substrates for the cyclooxygenase (COX) or lipooxygenase (LOX) pathways generating eicosanoids. Although not statistically significant, the reduced content of 20 : 4n-6 shown in this study might be due to an increased metabolism of this fatty acid into eicosanoids.
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Affiliation(s)
- Kristina Hoffmann
- Institute of Biochemistry and Food Chemistry, University of Hamburg, Hamburg, Germany
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Dieckmann KP, Pichlmeier U. Clinical epidemiology of testicular germ cell tumors. World J Urol 2004; 22:2-14. [PMID: 15034740 DOI: 10.1007/s00345-004-0398-8] [Citation(s) in RCA: 193] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2004] [Accepted: 01/22/2004] [Indexed: 01/22/2023] Open
Abstract
Clinical epidemiology is sometimes called the basic science of clinical medicine. In terms of the pathogenesis of testicular germ cell tumors (GCTs), clinical epidemiology analyzes suspected risk factors. The present review highlights the risk factors established so far and briefly summarizes those factors currently under investigation. In analogy to the methods of evidence based medicine, this review attributes levels of evidence to each of the putative risk factors. Level I represents highest quality of evidence while level V denotes the lowest level. So far, undescended testis (UDT), contralateral testicular GCT and familial testis cancer are established risk factors attaining high levels of evidence (levels I-III a). In a meta-analysis of 21 studies exploring the association of UDT with GCT risk, an over-all relative risk (RR) of 4.8 (95% confidence interval 4.0-5.7) was found. Contralateral testicular GCT involves a roughly 25-fold increased RR of GCT, while familial testis cancer constitutes a RR of 3-10. Infertility, testicular atrophy, and twin-ship represent risk factors with lesser levels of evidence (level III a). There is also some evidence for HIV infection being a predisposing factor for GCT (level IV a). Scrotal trauma is probably not associated with GCT risk. The estrogen excess theory implies high estrogen levels during the first trimester of pregnancy. As a consequence, primordial germ cells lose track of the normal developmental line and transform into premalignant cells that later become testicular intraepithelial neoplasia (TIN), the precursor of full-blown testicular GCT. Surrogate parameters for high gestational estrogen levels are investigated in case control studies. Such factors are maternal age >30 years, first-born, low birth weight, maternal breast cancer, high sex-ratio of siblings. So far, the sum of evidence is promising but still conflicting (especially for level III b). Another novel theory is the childhood nutrition hypothesis. This concept postulates a modulating or "catalyzing" effect by high dietary intake during childhood on the pathogenesis of testicular GCT. A surrogate parameter of early childhood nutrition is adult height. So far, 12 controlled studies have looked to the possible association of attained height and GCT risk of which six demonstrated a significant association. Thus, the sum of evidence corresponds to level III b. This concept is appealing because it would explain several hitherto unexplained epidemiological features of GCT.
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Affiliation(s)
- K-P Dieckmann
- Urologische Abteilung, Albertinen-Krankenhaus, Süntelstrasse 11a, D-22 457 Hamburg, Germany.
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