Testicular cancer is a disease characterized by the formation of malignant cells in the tissues of one or both testicles. While a relatively rare form of cancer, it is the most common cancer diagnosed in men between the ages of 15 and 35. This disease has a high curability rate, particularly when it is identified and treated early. Understanding the factors that increase a man’s chance of developing this cancer is important for awareness and can aid in early recognition.
Congenital and Developmental Conditions
The most significant risk factor present at birth is cryptorchidism, a condition where one or both testicles fail to descend from the abdomen into the scrotum. Men born with an undescended testicle are several times more likely to develop testicular cancer than men whose testicles descended normally. This increased risk is thought to be related to an underlying abnormality in the testicle itself, not its physical location.
Even if the testicle moves down on its own or is surgically moved into the scrotum in a procedure called orchiopexy, the risk remains elevated. The risk is also higher for testicles that remain in the abdomen compared to those that stop in the groin area. Another developmental condition, hypospadias, where the opening of the urethra is not at the tip of the penis, has also been associated with an increased risk.
Personal and Family Medical History
A personal history of cancer in one testicle is a strong predictor for developing cancer in the other. A family history of the disease also increases risk. Having a father or, particularly, a brother with testicular cancer increases an individual’s risk, suggesting a genetic component, though most men who get testicular cancer do not have a family history of it.
Another relevant condition is Testicular Germ Cell Neoplasia in Situ (GCNIS), formerly known as carcinoma in situ. GCNIS is a non-invasive condition involving abnormal cells within the small tubes of the testicle where sperm are produced. It is considered a precursor, as these cells can become cancerous if untreated, and is typically found incidentally during a testicular biopsy for other reasons, such as infertility.
Demographic Factors
Age is one of the most distinct factors; the disease is most frequently diagnosed in adolescents and young men, with a peak incidence between the ages of 20 and 35. The risk of developing testicular cancer is highest among white men, particularly those of European descent, with an incidence several times higher than in Black or Asian American men. The reasons for these racial and ethnic differences are not currently understood.
Geography is another factor, with the highest rates of testicular cancer found in the United States and Europe. Conversely, the incidence is lowest among men living in Africa and Asia. These patterns provide clues but do not offer definitive explanations.
Unproven and Debunked Factors
Public concern often focuses on causes that are not supported by scientific evidence. Studies have not shown a link between getting a vasectomy and an increased risk for testicular cancer. Similarly, physical injury or trauma to the testicles is a frequent source of worry but is not a cause of the cancer itself. An injury might, however, lead a person to discover a pre-existing lump.
There is no evidence that wearing tight underwear or pants causes testicular cancer. Activities like bicycling, which involve pressure on the groin area, have also not been shown to be a risk factor. Separating these myths from medically confirmed risks allows for a more accurate understanding of the disease.