Testicular cancer risks and causes
This page is about testicular cancer risk factors. We don't know exactly what causes testicular cancer but several factors are known to increase the risk of developing it. There is information about
- A quick guide to what's on this page
- How common testicular cancer is
- What a risk factor is
- Undescended testicle
- Carcinoma in situ of the testicle
- Fertility problems
- Previous cancer
- Family history
Testicular cancer risks and causes
Testicular cancer is a relatively rare disease in the UK. We don't know exactly what causes it but there are several factors that can increase the risk of developing it.
Your medical history
If an undescended testicle is not corrected by the age of 11, a man’s risk of testicular cancer is increased.
Carcinoma in situ (CIS) means that there are abnormal cells in the testicle. This is not cancer. But if left untreated, CIS may develop into cancer. Men who have had testicular cancer also have an increased risk of developing cancer in the other testis. There is a small increase in risk in men who've had fertility problems.
Other risk factors
Having a brother or father with testicular cancer increases the risk. Researchers think that up to 1 in 5 testicular cancers (20%) could be due to inherited gene changes (faults).
Ethnic background affects risk. In the UK it is more common in white men than men of other ethnic groups. We don't know why this is.
You can view and print the quick guides for all the pages in the about testicular cancer section.
Testicular cancer is a relatively rare disease. Around 2,200 men are diagnosed in the UK each year. That's about 1 out of every 100 cancers (1%) diagnosed in men.
Anything that increases your risk of getting a disease is a risk factor. Different cancers have different risk factors. Having one or more risk factors of a disease does not mean that you will definitely get it.
We know of some risk factors for testicular cancer and we describe these on this page. Researchers are also looking into other possible factors that might affect risk.
The most important risk factor for testicular cancer is undescended testicle (cryptorchidism). In the womb, the testicles develop in a male baby's abdomen. They usually move down into the scrotum at birth, or within the first year of life. If they move down later, or need surgery to bring them down this is called undescended testicle. A review of published studies in 2012 showed that in this situation there is a 3 times increase in the risk of testicular cancer. As testicular cancer is rare, the risk is still small.
In most men the testicles move down by the age of puberty, or they have surgery to bring them down. In men where the condition is not corrected by the age of 13, the risk of testicular cancer is increased by up to 5 times.
Carcinoma in situ (CIS) means that there are abnormal cells in the testicle. But they are completely contained and so cannot spread, as cancer cells can. Carcinoma in situ of the testicle is not cancer. But if left untreated, it will develop into cancer in about half the men who have it (50%). There is no lump and usually no other symptom. CIS is most often found when a man has a testicular biopsy to investigate infertility. CIS can be treated by removing the testicle, to prevent a testicular cancer from developing.
For some time, doctors have suspected that testicular cancer was linked to fertility problems and poor sperm quality. Studies have confirmed that men with fertility problems have an increased risk of testicular cancer. The problems they identified were low semen concentration, sperm that did not move around as much as normal, or a high proportion of abnormal sperm.
There is a significant link between infertility and testicular cancer risk. But as the overall risk of testicular cancer is small, this means there is only really a small increase in risk for men with fertility problems. Out of 32,000 men with fertility problems in one Danish study, researchers found that 89 testicular cancers had been diagnosed.
Men who have had testicular cancer have a 12 times increase in their risk of developing a second testicular cancer in the other testis. So it is important for them to attend follow up appointments after treatment.
Men who have had a germ cell cancer outside the testicle are at a higher risk of developing a testicular cancer than other men in the population.
Brothers or sons of men who have had testicular cancer have an increased risk of testicular cancer. Men whose father had testicular cancer are 4 times more likely to develop it and men with a brother who had testicular cancer are 9 times more likely to develop it.
In 2009 researchers found that some of the increase in risk was caused by changes in certain genes. But they believe that there are more gene changes to be found and they are working on identifying them. In the future this could lead to a test to find men at higher risk of testicular cancer.
The UK genetics of testicular cancer study is trying to find genes that may increase the risk. More than 3,000 men who have had testicular cancer will give a small sample of blood. Researchers will then look at the samples to find any possible genes that could increase the risk of testicular cancer. The trial will end in 2016 so the results are not likely to be available for many years.
Men who are born with an abnormality of the penis and urethra called hypospadias are more likely to develop testicular cancer than men in the general population. Men who have inguinal hernia are also more likely to develop it. An inguinal hernia is a lump in the groin area caused by a part of the intestine (bowel) slipping through a weakness in the abdominal (tummy) wall.
A combined analysis of published studies has shown that men with HIV or AIDS have an increased risk of testicular cancer.
Testicular cancer is more common in some racial and social groups. In the UK, a study has shown that white men have a higher risk of testicular cancer than men from other ethnic groups. We do not know why this is.
Doctors call calcium in the testicles testicular microlithiasis (pronounced mike-row-lith-eye-a-sis). It is often found by chance, so it is difficult to know how many men have it. Researchers think that it affects between 2 and 6 out of every 100 men (2% to 6%)..Doctors usually diagnose testicular microlithiasis (TM) with an ultrasound scan. They often find it when they are checking testicular symptoms, such as pain or swelling in the testicle.
Although studies have shown a link between TM and testicular cancer, a recent analysis of the research found no increase in testicular cancer risk for men with TM who were otherwise healthy. But men who had TM and also had other testicular cancer risk factors (such as fertility problems or undescended testicle) had an increased risk of testicular cancer.
If you have these calcium specks in the testicles, researchers recommend that your doctor should keep a watch on your symptoms. But there are no guidelines on how your doctor should monitor you. So your GP should talk the situation through with you and then you can both make a decision based on what is best in your case. Most importantly, if you have TM and notice any swelling in your testicle, you should see your doctor straight away.
There is evidence that men who are taller than average have an increased risk of testicular cancer and men who are shorter than average have a reduced risk.
There is no known link between injury or sporting strains and testicular cancer. But an injury often causes swelling and lumps in the testicle and this can make a tumour difficult to spot. If you have injured your testicles and have any swelling, go to your GP for a check up.
Some research evidence shows that the levels of certain hormones in the mother in early pregnancy may affect the risk of testicular cancer in their sons. One study showed that higher levels of a hormone known as dehydroepiandrosterone sulphate gave a lower risk of testicular cancer. But higher levels of androstenedione and oestradiol may increase the risk. One study showed that sons of women with lower levels of oestradiol and oestriol in early pregnancy had a higher risk of undescended testicle than the general population. More studies are needed to see if mother's hormone levels during pregnancy can really affect testicular cancer risk.
Doctors used to prescribe a drug called diethylstilbestrol (DES) to some pregnant women with a history of pregnancy problems. There has been a lot of research to see if exposure to DES in the womb increases the risk of testicular cancer. But a meta-analysis of the research did not found a significantly higher incidence of testicular cancer in DES exposed boys. There is a higher frequency of undescended testicle in boys born to DES mothers. Undescended testicle is a risk factor for testicular cancer, so there could be an indirect link.
Men whose mothers had bleeding during pregnancy have a higher risk of testicular cancer. But men who have older brothers and sisters have a lower risk. A low birth weight can increase the risk of an undescended testicle. But it is unclear whether birth weight directly affects testicular cancer risk.
Twins have an increased risk of testicular cancer, especially if they are identical or if they are both boys. But as testicular cancer is so rare the risk is still low.
There is no known link between vasectomy and testicular cancer. Early research suggested a link, but this has since been shown to be untrue.
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