Male reproductive disorders in humans and prenatal indicators of estrogen exposure A review of published epidemiological studies, 2006.
Cryptorchidism is an established risk factor, but the relative risk has been downgraded by newer and better studies. However, only about 10% of men with the disease have or have had undescended testes reflecting a lifetime risk in cryptorchid men of 2–3% corresponding to a risk which is about four times higher than in the general population. The peak incidence in young adults as well as the association with cryptorchidism and carcinoma in situ suggests that causal factors operate early in life.
We found 22 epidemiological studies exploring prenatal estrogen and the risk of testicular cancer. In nine studies hormones given early in pregnancy were evaluated but only few studies provide information on type of hormones. The most informative study is by Strohsnitter et al. who examined DES related testicular cancer in four different cohorts of 1709 exposed and 1904 non-exposed men. Data on drug doses and timing are of high quality. They found an elevated risk of testicular cancer in the exposed group [RR = 3.05 (0.65–21.96)]. In this study the risk for recall and selection bias is limited.
The epidemiological studies support the hypothesis that testicular cancer is associated with a higher prenatal estrogen exposure, except for inconsistent findings in studies of maternal obesity and preeclampsia.
- Male reproductive disorders in humans and prenatal indicators of estrogen exposure A review of published epidemiological studies, Reproductive toxicology, DOI: 10.1016/j.reprotox.2005.05.006, 2006.
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