To explore risk factors for testicular cancer and cryptorchidism, two parallel case-control studies were conducted in Denmark. The testicular cancer study was population-based and included 514 cases and 720 controls. The cryptorchidism study included 387 cases and 416 controls and was based on two hospital series of men treated for cryptorchidism and a control group sampled among residents in the Copenhagen area. The 2,037 men were interviewed by telephone. The relative risk (RR) of testicular cancer in men with treated or persisting cryptorchidism was 3.6 (95 percent confidence interval = 1.8–6.9), but no increase in risk was seen in the six to seven percent of the men who reported a history of undescended testes that descended spontaneously. The RR in men who were treated for cryptorchidism increased with age at treatment. This effect may be due wholly or in part to increased treatment of boys with testes that would have descended spontaneously if they had not been treated. Cryptorchidism and inguinal hernia may be confused and reported interchangeably. In the absence of cryptorchidism or testicular atrophy, clinical inguinal hernia was not associated with testicular cancer. Testicular atrophy was associated with both testicular cancer and cryptorchidism. Associations with other congenital malformations were few and based on small numbers.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Møller H. Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology. Eur Urol 1993; 23: 8–13.
Morrison AS. Cryptorchidism, hernia, and cancer of the testis. JNCI 1976; 56: 731–3.
Henderson BE, Benton B, Jing J, Yu MC, Pike MC. Risk factors for cancer of the testis in young men. Int J Cancer 1979; 23: 589–602.
Schottenfeld D, Warshauer ME, Scherlock S, Zauber AG, Leder M, Payne R. The epidemiology of testicular cancer in young adults. Am J Epidemiol 1980; 112: 232–46.
Coldman AJ, Elwood JM, Gallagher RP. Sports activities and risk of testicular cancer. Br J Cancer 1982; 46: 749–56.
Depue RH, Pike MC, Henderson BE. Estrogen exposure during gestation and risk of testicular cancer. JNCI 1983; 71: 1151–5.
Mills PK, Newell GR, Johnson DE. Testicular cancer associated with employment in agriculture and oil and natural gas extraction. Lancet 1984; i: 207–10.
Pottern LM, Brown LM, Hoover RN, et al. Testicular cancer risk among young men: role of cryptorchidism and inguinal hernia. JNCI 1985; 74: 377–81.
Moss AR, Osmond D, Bacchetti P, Torti FM, Gurgin V. Hormonal risk factors in testicular cancer. A case-control study. Am J Epidemiol 1986; 124: 39–52.
Giwercman A, Grindsted J, Hansen B, Jensen OM, Skakkebæk NE. Testicular cancer risk in boys with maldescended testis: a cohort study. J Urol 1987; 138: 1214–6.
Brown LM, Pottern LM, Hoover RN. Testicular cancer in young men: the search for causes of the epidemic increase in the United States. J Epidemiol Comm Health 1987; 41: 349–54.
Swerdlow AJ, Huttly SR, Smith PG. Testicular cancer and antecedent diseases. Br J Cancer 1987; 55: 97–103.
Strader CH, Weiss NS, Daling JR, Karagas MR, McKnight B. Cryptorchism, orchiopexy, and the risk of testicular cancer. Am J Epidemiol 1988; 127: 1013–8.
Haughey BP, Graham S, Brasure J, Zielezny M, Sufrin G, Burnett WS. The epidemiology of testicular cancer in upstate New York. Am J Epidemiol 1989; 130: 25–36.
Pinczowski D, McLaughlin JK, Lackgren G, Adami HO, Persson I. Occurrence of testicular cancer in patients operated on for cryptorchidism and inguinal hernia. J Urol 1991; 146: 1291–4.
United Kingdom Testicular Cancer Study Group. Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility, and exercise. BMJ 1994; 308: 1393–9.
Berthelsen JG, Skakkebæk NE, von der Maase H, Sørensen BL, Mogensen P. Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer. Br Med J Clin Res Ed 1982; 285: 1683–6.
Harland SJ, Cook PA, Fossa SD, et al. Risk factors for carcinoma in situ of the contralateral testis in patients with testicular cancer. An interim report. Eur Urol 1993; 23: 115–8.
Chilvers CE, Pike MC, Peckham MJ. Torsion of the testis: a new risk factor for testicular cancer. Br J Cancer 1987; 55: 105–6.
Vahlensieck W, Weissbach L, Hildenbrand G. Five-year register and multicenter study for testicular tumours Bonn. Int Urol Nephrol 1984; 16: 149–56.
Tollerud DJ, Blattner WA, Fraser MC, et al. Familial testicular cancer and urogenital developmental anomalies. Cancer 1985; 55: 1849–54.
Karagas MR, Weiss NS, Strader CH, Daling JR. Elevated intrascrotal temperature and the incidence of testicular cancer in noncryptorchid men. Am J Epideminl 1989; 129: 1104–9.
Lykkesfeldt G, Bennett P, Lykkesfeldt AE, et al. Testis cancer. Ichthyosis constitutes a significant risk factor. Cancer 1991: 67: 730–4.
Collins GM, Kim DU, Logrono R, Rickert RR, Zablow A, Breen JL. Pure seminoma arising in androgen insensitivity syndrome (testicular feminization syndrome): a case report and review of the literature. Mod Pathol 1993; 6: 89–93.
Müller J, Skakkebæk NE. Gonadal malignancy in individuals with sex chromosome anomalies. Birth Defects 1990; 26: 247–55.
Verp MS, Simpson JL. Abnormal sexual differentiation and neoplasia. Cancer Genet Cytogenet 1987; 25: 191–218.
Skakkebæk NE, Berthelsen JG, Giwercman A, Müller J. Carcinoma-in-situ of the testis: possible origin from gonocytes and precursor of all types of germ cell tumours except spermatocytoma. Int J Androl 1987; 10: 19–28.
Brown LM, Pottern LM, Hoover RN. Prenatal and perinatal risk factors for testicular cancer. Cancer Res 1986; 46: 4812–6.
Swerdlow AJ, Huttly SR, Smith PG. Prenatal and familial associations of testicular cancer. Br J Cancer 1987; 55: 571–7.
Prener A, Hsieh C-c, Engholm G, Trichopoulos D, Jensen OM. Birth order and risk of testicular cancer. Cancer Causes Control 1992; 3: 265–72.
Gershaman ST, Stolley PD. A case-control study of testicular cancer using Connecticut tumour registry data. Int J Epidemiol 1988; 17: 738–42.
UK Testicular Cancer Study Group. Social, behavioural and medical factors in the aetiology of testicular cancer: results from the UK study. Br J Cancer 1994; 70 513–20.
Depue RH, Pike MC, Henderson BE. Cryptorchidism and testicular cancer. JNCI 1986; 77: 830–3.
Chilvers C, Pike MC. Epidemiology of undescended testis. In: Oliver RTD, Blandy JP, Hope-Stone HF eds. Urological and Genital Cancer. Oxford, UK: Blackwell Scientific Publications; 1989; 306–21.
Coscrove MD, Benton B, Henderson BE. Male genitourinary abnormalities and maternal diethylstilbestrol. J Urol 1977; 117: 220–2.
Depue RH. Maternal and gestational factors affecting the risk of cryptorchidism and inguinal hernia. Int J Epidemiol 1984; 13: 311–8.
Depue RH. Cryptorchidism, and epidemiologic study with emphasis on the relationship to central nervous system dysfunction. Teratology 1988; 37: 301–5.
Bernstein L, Pike MC, Depue RH, Ross RK, Moore JW, Henderson BE. Maternal hormone levels in early gestation of cryptorchid males: a case-control study. Br J Cancer 1988; 58: 379–81.
Berkowitz GS, Lapinsky RH, Godbold JH, Dolgin SE, Holzman IR. Maternal and neonatal risk factors for cryptorchidism. Epidemiology 1995; 6: 127–31.
Beard CM, Melton LJ, O'Fallon WM, Noller KL, Benson RC. Cryptorchism and maternal estrogen exposure. Am J Epidemiol 1984; 120: 707–16.
Davies TW, Williams DR, Whitaker RH. Risk factors for undescended testis. Int J Epidemiol 1986; 15: 197–201.
Bjoro K, Dybvik T. Testicular retention. Age at diagnosis and surgical correction at a county hospital. Tidsskr Nor Laegeforen 1984; 104: 14–6.
Swerdlow AJ, Wood KH, Smith PG. A case-control study of the aetiology of cryptorchidism. J Epidemiol Comm Health 1983; 37: 238–44.
John Radcliffe Hospital Cryptorchidism Study Group. Cryptorchidism: a prospective study of 7500 consecutive male births, 1984–8. Arch Dis Child 1992; 67: 892–9.
Jackson MB. The epidemiology of cryptorchidism. John Radcliffe Hospital Cryptorchidism Research Group. Horm Res 1988; 30: 153–6.
Hjertkvist M, Damber JE, Bergh A. Cryptorchidism: a registry based study in Sweden on some factors of possible aetiological importance. J Epidemiol Comm Health 1989; 43: 324–9.
Mori M, Davies TW, Tsukamoto T, Kumamoto Y, Fukuda K. Maternal and other factors of cryptorchidism—a case-control study in Japan. Kurume Med J 1992; 39: 53–60.
Storm HH. The Danish Cancer Registry, a Self-reporting National Cancer Registration System with Elements of Active Data Collection. Lyon, France: International Agency for Research on Cancer, 1991; IARC Sci Pub. No. 95: 220–36.
Giwereman A, Bruun E, Frimodt Meller C, Skakkebæk NE. Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J Urol 1989; 142: 998–1001.
Breslow NE, Day NE. Statistical Methods in Cancer Research. Volume I. The Analysis of Case-control Studies. Lyon, France: International Agency for Research on Cancer, 1980. IARC Sci Pub. No. 32: 5–338.
Prener A, Engholm G, Jensen OM. Genital anomalies and risk for testicular cancer in Danish men. Epidemiology 1996 (in press).
Blom K. Undescended testis and time of spontaneous descent in 2516 schoolboys. Ugeskr Laeger 1984; 146: 616–7.
Villumsen AL, Zachau-Christiansen B. Spontaneous alterations in position of the testes. Arch Dis Childhood 1996; 41: 198–200.
Scorer CG, Farrington GH. Congenital Deformities of the Testis and Epididymis. London, UK: Butterworths, 1971.
Palmer JM. The undescended resticle. Endocrinol Metab Clin North Am 1991; 20: 231–40.
Chilvers C, Pike MC, Forman D, Fogelman K, Wadsworth ME. Apparent doubling of frequency of undescended testis in England and Wales in 1962–81. Lancet 1984; ii: 330–2.
Sharpe RM, Skakkebæk NE. Are oestrogens involved in falling sperm counts and disorders of the male reproductive tract? Lancet 1993; 341: 1392–5.
Rajpert-De Meyts E, Skakkebæk NE. The possible role of sex hormones in the development of testicular cancer. Eur Urol 1993; 23: 54–9.
Lee PA. Fertility in cryptorchidism. Does treatment make a difference? Endocrinol Metab Clin North Am 1993; 22: 479–90.
Forman D, Gallagher R, Møller H, Swerdlow TJ. Aetiology and epidemiology of testicular cancer: report of consensus group. Prog Clin Biol Res 1990; 357: 245–53.
Oliver RT. Atrophy, hormones, genes and viruses in aetiology of germ cell tumours. Cancer Surv 1990; 9: 263–86.
Østerlind A, Berthelsen JG, Abildgaard N, et al. Risk of bilateral testicular germ cell cancer in Denmark: 1960–1984. JNCI 1991; 83: 1391–5.
Berthelsen JG, Skakkebæk NE. Gonadal function in men with testis cancer. Fertil Steril 1983; 39: 68–75.
Swerdlow AJ, Huttly SR, Smith PG. Testicular cancer and antecedent diseases. Br J Cancer 1987; 55: 97–103.
Additional information
Henrik Møller is at the Center for Research in Health and Social Statistics, Copenhagen, Denmark. Authors were also affiliated with The Danish Cancer Registry at The Danish Cancer Society, Copenhagen, Denmark (Drs Møller and Prener), and with International Agency for Research on Cancer, Lyons, France (Dr Møller). Dr Skakkebak is with the Department ofGrowth and Reproduction, National University Hospital, Copenhagen, Denmark. Address correspondence to Dr Møller, Center for Research in Health & Social Studies, Sejrøgade II, DK-2100 Copenhagen, Denmark. The study was supported by grants from The Danish Cancer Society and The Danish Medical Research Council.
Rights and permissions
About this article
Cite this article
Møller, H., Prener, A. & Skakkebxk, N.E. Testicular cancer, cryptorchidism, inguinal hernia, testicular atrophy, and genital malformations: case-control studies in Denmark. Cancer Causes Control 7, 264–274 (1996). https://doi.org/10.1007/BF00051302
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00051302