Etiologic factors in testicular germ cell tumors

Several case reports have noted the occurrence of testicular cancer in DES sons

2009 Paper Abstract

Globally, testicular cancer incidence is highest among men of northern European ancestry and lowest among men of Asian and African descent. Incidence rates have been increasing around the world for at least 50 years, but mortality rates, at least in developed countries, have been declining. While reasons for the decreases in mortality are related to improvements in therapeutic regimes introduced in the late 1970s, reasons for the increase in incidence are less well understood. An accumulating body of evidence suggests, however, that testicular cancer arises in fetal life. Perinatal factors, including exposure to endocrine disrupting chemicals, have been suggested to be related to risk.

“The effect of exogenous, as well as endogenous, hormone exposure has also been examined. Diethylstilbestrol (DES), a nonsteroidal estrogen first synthesized in 1938, is several times more potent than the endogenous estrogen, 17β-estradiol. Prescribed to prevent miscarriage between the late 1940s and mid 1970s, DES was removed from the market after being associated with clear cell adenocarcinoma of the vagina and cervix among daughters of exposed women. Several case reports have noted the occurrence of testicular cancer in sons of DES-exposed mothers, and a multi-center study reported a non-significant three-fold risk of TGCT based on seven cases in the exposed group and two cases in the non-exposed group. Other researchers have reported conflicting results and reviews of the literature have concluded, in general, that the supporting data are equivocal.”



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