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A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking and diet, can be changed. Others, like a person’s age or family history, can’t be changed.
But having a risk factor, or even many, does not mean that you will get the disease. Just as not having risk factors doesn’t mean you won’t get the disease. And some people who get the disease may not have had any known risk factors. Even if a person with testicular cancer has a risk factor, it’s often very hard to know how much that risk factor contributed to the cancer.
Scientists have found few risk factors that make someone more likely to develop testicular cancer. Most boys and men with testicular cancer don't have any of the known risk factors. Risk factors for testicular cancer include:
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 from the abdomen (belly) into the scrotum before birth. Males with cryptorchidism are many times more likely to get testicular cancer than those with normally descended testicles.
Normally, the testicles develop inside the abdomen of the fetus and they go down (descend) into the scrotum before birth. But in about 3% of boys, the testicles do not make it all the way down before the child is born. Sometimes one or both testicles stay in the abdomen. In other cases, the testicles start to descend but stay in the groin area.
Most of the time, undescended testicles continue moving down into the scrotum during the child’s first year of life. If the testicle hasn't descended by the time a child is a year old, it probably isn’t going to do it on its own. Sometimes a surgical procedure known as orchiopexy is needed to move the testicle down into the scrotum.
The risk of testicular cancer might be a little higher for men whose testicle stayed in the abdomen as opposed to one that has descended at least partway. If cancer does develop, it's usually in the undescended testicle, but about 1 out of 4 cases occur in the normally descended testicle. Because of this, some doctors conclude that cryptorchidism doesn’t actually cause testicular cancer, but that there's something else that leads to both testicular cancer and abnormal positioning of one or both testicles.
Orchiopexy may reduce the risk of testicular cancer if it's done when a child is younger, but it's not as clear if it's helpful if the child is older. The best time to do this surgery is not clear. Experts in the United States recommend that orchiopexy be done soon after the child’s first birthday for reasons that aren't related to cancer (such as fertility).
Having a father or brother with testicular cancer increases the risk that you will get it, too. But only a small number of testicular cancers occur in families. Most men with testicular cancer do not have a family history of the disease.
Klinefelter's syndrome is an inherited disease that's also linked to an increased risk of testicular cancer.
Some evidence has shown that men infected with the human immunodeficiency virus (HIV), particularly those with AIDS, are at increased risk. No other infections have been shown to increase testicular cancer risk.
This condition, described in What Is Testicular Cancer? often doesn’t cause a lump in the testicles or any other 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 numbers 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 if 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. When CIS is treated, radiation or surgery (to remove the testicle) is used.
A personal history of testicular cancer is another risk factor. About 3% or 4% of men who have been cured of cancer in one testicle will at some point develop cancer in the other testicle.
About half of testicular cancers occur in men between the ages of 20 and 34. But this cancer can affect males of any age, including infants and elderly men.
The risk of testicular cancer among White men is about 4 to 5 times that of Black and Asian American men. The risk for American Indian men is 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 and lowest among men living in Africa or Asia.
Several studies have found that tall men have a somewhat higher risk of testicular cancer, but some other studies have not. Most studies have not found a link between testicular cancer and body weight.
Prior injury or trauma to the testicles and recurrent actions such as horseback riding do not appear to be related to the development of testicular cancer.
Most studies have not found that strenuous physical activity increases testicular cancer risk. Being physically active has been linked with a lower risk of several other forms of cancer as well as a lower risk of many other health problems.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Society of Clinical Oncology. Testicular Cancer: Risk Factors. 09/2016. Accessed at www.cancer.net/cancer-types/testicular-cancer/risk-factors on April 26, 2018.
Boccellino M, Vanacore D, Zappavigna S, et al. Testicular cancer from diagnosis to epigenetic factors. Oncotarget. 2017 Sep 18;8(61):104654-104663.
Loveday C, Litchfield K, Levy M, et al. Validation of loci at 2q14.2 and 15q21.3 as risk factors for testicular cancer. Oncotarget. 2017;9(16):12630-12638.
National Cancer Institute. Testicular Cancer Screening (PDQ®)–Patient Version. January 30, 2018. Accessed at www.cancer.gov/types/testicular/patient/testicular-screening-pdq#section/_8 on April 26, 2018.
National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Testicular Cancer, Version 2.2018 -- February 16, 2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/testicular.pdf on April 26, 2018.
Smith ZL, Werntz RP, Eggener SE. Testicular Cancer: Epidemiology, Diagnosis, and Management. Med Clin N Am. 2018;102:251-264.
Last Revised: May 17, 2018
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