DES Incidence of Testicular Cancer : Not Enough Evidence Yet

Do Environmental Estrogens Contribute to the Decline in Male Reproductive Health ? 1995

Selected Abstracts

Testicular cancer is now the most common malignancy of young men in many countries; although it is still rare compared with the malignant diseases most prevalent in old age, the lifetime risk of developing testicular cancer now approaches 1% in Denmark. The incidence of testicular cancer has been increasing for several decades. On the basis of data from several cancer registries, increases in incidence are evident in England and Wales, Scotland, the Nordic and Baltic countries, Australia, New Zealand, and the US. The observed increase has been 2-4% per annum in men younger than age 50 and has occurred in those between ages 20 and 45 years, in whom the incidence of testicular cancer is highest. Marked differences in race and in geographical areas exist; e.g., the incidence in Denmark is fourfold higher than in Finland, and whites are three fold more susceptible to this disease than are blacks in the US. We do not know the etiology of testicular cancer and therefore cannot prevent the disease.

The structural abnormalities of the reproductive organs more frequently reported in males exposed to DES than in controls include meatal stenosis, hypospadias, epididymal cysts, and testicular abnormalities.

Not enough evidence exists to indicate an increased risk of testicular cancer in men exposed to DES, but the case-control studies thus far performed include major design problems.

  • Hormone treatment may have been initiated at variable times during pregnancy; therefore, the presumed critical period when adverse effects of estrogens might occur may have been missed in some of these studies.
  • Furthermore, the exact prescribed hormone and the dose are often not remembered and therefore some women may have been treated with only progesterone.
  • Also, the number of cases has been too small to determine whether a substantial difference truly exists, and recall bias may also be present.

References

  • Full study (free access) Do environmental estrogens contribute to the decline in male reproductive health?, Clinical chemistry, NCBI PubMed, PMID: 7497651, 1995.
  • Trends in age-standardized (world standard population) incidence rates of testicular cancer featured image aaccjnls.
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