Some facts about testicular cancer

Cancer of the testicle can develop in one or both testicles in males of any age, including infants and elderly men. Almost half of all cases of testicular cancer are in men between the ages of 20 and 34.

Testicular cancer is not common; a man's lifetime chance of getting it is about 1 in 270. The risk of dying from this cancer is about 1 in 5,000.

Testicular cancer can be treated and usually cured, especially when it is found early. If you have any of the signs or symptoms described above, see a doctor right away. You may not have testicular cancer, but if you do, the sooner you start treatment, the more likely it is to work. For more information, see our document called Testicular Cancer.

What factors increase your risk for testicular cancer?

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. Age is also a risk factor for many cancers. But having a risk factor, or even many, does not mean that you will get the disease.

Scientists have found few risk factors that are linked to a higher risk of testicular cancer. But because this cancer is rare, even a small increase in risk still makes the chance of ever getting it low. And if a man has one or more risk factors for this disease, there is no way to know for sure how much they contributed to developing the cancer. Most men with testicular cancer do not have any known risk factors.

Undescended testicle

One of the main risk factors for testicular cancer is a condition called cryptorchidism, or undescended testicle(s). This means that one or both testicles fail to move into the scrotum before birth. Males with cryptorchidism are several times more likely to get testicular cancer than those with normally descended testicles. Normally, the testicles develop inside the belly of the fetus, and move into the scrotum before birth. But in about 3% of boys (1 in 33), the testicles do not make it all the way down before the child is born. Sometimes the testicle stays in the belly. In other cases, the testicle starts to descend but gets stuck in the groin area.

Most of the time, undescended testicles keep moving down into the scrotum during the child's first year of life. If the testicle has not fully descended by the time a child is a year old, it probably won't go down on its own. Sometimes a surgery called orchiopexy is needed to bring the testicle down into the scrotum.

Men who have had an undescended testicle have a higher risk of testicular cancer. The risk of testicular cancer may be somewhat higher for men whose testicle stayed in the abdomen as opposed to one that has descended at least partway. Most cancers develop in the undescended testicle, but about 1 out of 4 cases occur in the normally descended testicle. Based on these observations, some doctors conclude that cryptorchidism doesn't actually cause testicular cancer but that there is something else that leads to both testicular cancer and abnormal positioning of one or both testicles.

Orchiopexy done when a child is younger may be more likely to reduce the risk of testicular cancer than surgery that is done when the child is older. Still, the best time to do this surgery to reduce the risk of testicular cancer is not clear. Experts in the United States recommend that orchiopexy be done soon after the child's first birthday for reasons (such as fertility) that are not related to cancer.

Family history

Men with testicular cancer in their families have a higher risk. If a man has the disease, there is an increased risk that his brothers or sons will also develop it. But only about 3% of testicular cancer cases are actually found to run in families, so most men are unlikely to pass this disorder on to their children. Most men with testicular cancer don't have it in the family.

Cancer of the other testicle

A man who has had testicular cancer is at higher risk of having it again. About 3% or 4% of men who have been cured of cancer in one testicle will at some time develop cancer in the other testicle.

Carcinoma in situ

Carcinoma in situ (CIS) of the testicles is an overgrowth of cells that may progress to cancer. This condition does not usually produce a tumor or cause any symptoms. It isn't clear how often carcinoma in situ (CIS) in the testicles progresses to cancer. In some cases, CIS is found in men who have a testicular biopsy to evaluate infertility or have a testicle removed because of cryptorchidism. Doctors in Europe are more likely than the doctors in this country to look for CIS. This may be why the figures for diagnosis and progression of CIS to cancer are lower in the United States than in parts of Europe. Since we don’t know how often CIS becomes true (invasive) cancer, it isn’t clear that treating CIS is a good idea. Some experts think that it may be better to wait and see if the disease gets worse or becomes a true cancer. This could allow many men with CIS to avoid the risks and side effects of treatment. Radiation or surgery (to remove the testicle) is used to treat CIS.

Age

Testicular cancer can affect males of any age, but almost half of cases of are found in men between the ages of 20 and 34.

Race and ethnicity

The risk of testicular cancer among white men is about 5 times that of black men, and more than 3 times that of Asian Americans and American Indians. The risk for Latinos falls between that of Asian and white men. The reason for these differences is not known. Worldwide, the risk of developing this disease is highest among men living in the United States and Europe. It is lowest among men living in Africa or Asia.

HIV infection

Some research has shown that men infected with the human immunodeficiency virus (HIV), particularly those with AIDS, have an increased risk. No other infections have been shown to increase testicular cancer risk.

Body size

Some studies have found that the risk of testicular cancer is somewhat higher in tall men, but other studies have not.