Any substance or condition that increases cancer risk is referred to as a risk factor. There isn’t a known, single cause of testicular cancer. Most cancers are the result of many risk factors. However, some men with testicular cancer do not have any identifiable risk factors.
*Risk factors are generally listed in order from most significant to least significant. In most cases, it is impossible to rank the relative significance of individual risk factors with absolute certainty.
The incidence of testicular cancer has increased steadily over the last several decades, but the reasons for this increase are poorly understood. It is the most common cancer in young men 15–29 years of age. The incidence is lowest before puberty, increases significantly after age 14, peaks around age 30 and declines by age 60.
- The incidence of testicular cancer is higher in Caucasian men than in men of African and Asian ancestry.
- Testicular cancer occurs more commonly in men with higher socio-economic status.
The following factors are known to increase the risk of developing testicular cancer.
Undescended testicle (cryptorchidism)
Men with a history of undescended testicle (cryptorchidism) have a higher risk of testicular cancer. While a boy is a fetus in the womb, the testicles form in his abdomen. Normally they move down (descend) into the scrotum before birth. Sometimes this process fails and boys are born with an undescended testicle on one or both sides. The exact cause of this abnormality is still unclear. If the testicle does not descend on its own, usually during the first year of life, a surgeon will do an operation to bring the testicle into the scrotum (orchiopexy).
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Family history of testicular cancer
The brothers and sons of a man diagnosed with testicular cancer have a higher risk of developing this cancer themselves. Genetics may play a role in the development of testicular cancer.
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Personal history of testicular cancer
Having testicular cancer or carcinoma in situ in one testicle increases the chances that testicular cancer could develop in the other testicle.
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Klinefelter syndrome
Klinefelter syndrome is a rare genetic condition that affects male sexual development. Men with Klinefelter syndrome have an increased risk of testicular cancer.
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Possible risk factors
The following factors have some association with testicular cancer, but there is not enough evidence to say they are known risk factors. Further study is needed to clarify the role of these factors for testicular cancer.
- testicular microlithiasis (calcium specks in the testicle) – Studies show that men with testicular microlithiasis are more likely to develop testicular cancer.
- HIV infection or AIDS – Studies suggest that men with a weakened immune system due to HIV or AIDS (acquired immune deficiency syndrome caused by the HIV virus) have a slightly higher risk of developing testicular cancer.
- early puberty – Some studies suggest that men who enter puberty at an early age have a higher incidence of testicular cancer. Other studies have not shown a link between early puberty and testicular cancer.
- height – Several studies suggest an increased risk of testicular cancer in men who are taller than average. Other studies show no link between height and testicular cancer.
- decreased fertility – Decreased fertility (subfertility) is associated with testicular cancer. It is not clear if subfertility is a cause of testicular cancer or if the same disease process causes both decreased fertility and testicular cancer.
- pesticides – Some studies suggest that exposure to certain pesticides, such as organochlorine pesticides, increases the risk of testicular cancer.
- marijuana – Some studies suggest a possible link between marijuana use and testicular cancer.
- prenatal exposure to estrogens – Some studies suggest that the sons of mothers who took diethylstilbestrol (DES) have a higher risk of developing testicular cancer. DES is a form of estrogen used between 1940 and 1971 to treat women with certain problems during pregnancy (such as miscarriages).
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Factors not associated with testicular cancer
The following are not considered to be risk factors for testicular cancer because there is enough evidence showing that there is no association:
- vasectomy
- trauma or injury to the testicle
- tobacco
- alcohol
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Unknown risk factors
The following are factors for which there is not enough evidence or the evidence is inconclusive. In other words, it can’t be determined for sure whether these risk factors are or are not associated with testicular cancer.
- low or high birth weight
- diet
- environmental factors
- It is not known if exposure to the following is associated with testicular cancer:
- petroleum products
- preservatives
- naturally occurring toxins like mycotoxin ochratoxin A (OTA)
- viral infections – including infection with Epstein-Barr virus (EBV)
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See a list of questions to ask your doctor about risks. Find out how to reduce the risk of testicular cancer.