Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2009 Dec;38(6):1532-42.
doi: 10.1093/ije/dyp287. Epub 2009 Sep 23.

A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer--experiences of the mother

Michael B Cook  1 , Olof Akre, David Forman, M Patricia Madigan, Lorenzo Richiardi, Katherine A McGlynn
Affiliations
Meta-Analysis

A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer--experiences of the mother

Michael B Cook et al. Int J Epidemiol. 2009 Dec.

Abstract

Background: We undertook a systematic review and meta-analysis of perinatal variables in relation to testicular cancer risk, with a specific focus upon characteristics of the mother.

Methods: EMBASE, PubMed, Scopus and Web of Science databases were searched using sensitive search strategies. Meta-analysis was undertaken using STATA 10.

Results: A total of 5865 references were retrieved, of which 67 met the inclusion criteria and contributed data to at least one perinatal analysis. Random effects meta-analysis found maternal bleeding during pregnancy [odds ratio (OR) 1.33, 95% confidence interval (CI) 1.02-1.73], birth order (primiparous vs not, 1.08, 95% CI 1.01-1.16; second vs first, OR 0.94, 95% CI 0.88-0.99; third vs first, OR 0.91, 95% CI 0.83-1.01; fourth vs first, OR 0.80, 95% CI 0.69-0.94) and sibship size (2 vs 1, OR 0.93, 95% CI 0.75-1.15; 3 vs 1, OR 0.89, 95% CI 0.74-1.07; 4 vs 1, OR 0.75, 95% CI 0.62-0.90) to be associated with testicular cancer risk. Meta-analyses that produced summary estimates which indicated no association included maternal age, maternal nausea, maternal hypertension, pre-eclampsia, breech delivery and caesarean section. Meta-regression provided evidence that continent of study is important in the relationship between caesarean section and testicular cancer (P = 0.035), and a meta-analysis restricted to the three studies from the USA was suggestive of association (OR 1.67, 95% CI 1.07-2.56).

Conclusions: This systematic review and meta-analysis has found evidence for associations of maternal bleeding, birth order, sibship size and possibly caesarean section with risk of testicular cancer.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Forest plot of each variable's random effects meta-analytic summary estimate of association with testicular cancer
Figure 2
Figure 2
Forest plot of maternal bleeding and testicular cancer meta-analysis
Figure 3
Figure 3
Forest plot of birth order (primiparous vs not primiparous) and testicular cancer meta-analysis stratified by study design
Figure 4
Figure 4
Forest plot of birth order (categorical) and testicular cancer meta-analyses
Figure 5
Figure 5
Forest plot of sibship size (categorical) and testicular cancer meta-analyses
See this image and copyright information in PMC

References

    1. McGlynn KA, Devesa SS, Sigurdson AJ, Brown LM, Tsao L, Tarone RE. Trends in the incidence of testicular germ cell tumors in the United States. Cancer. 2003;97:63–70. - PubMed
    1. IARC. Cancer incidence in five continents. Vol. IX. IARC Sci Publ, No 160, 2008:1–897. - PubMed
    1. Muller J, Skakkebaek NE, Nielsen OH, Graem N. Cryptorchidism and testis cancer. Atypical infantile germ cells followed by carcinoma in situ and invasive carcinoma in adulthood. Cancer. 1984;54:629–34. - PubMed
    1. Skakkebaek NE, Berthelsen JG, Giwercman A, Muller 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. - PubMed
    1. Moller H. Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology. Eur Urol. 1993;23:8–13. discussion 4–5. - PubMed

Publication types