Division of Hormonal and Reproductive Epidemiology, National Cancer Institute, Suite 550 6120 Executive Boulevard, Rockville, MD 20852, USA.
Nat Rev Urol. 2012 Apr 17;9(6):339-49. doi: 10.1038/nrurol.2012.61.
The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because the risk factors for the disease are poorly understood. Some research suggests that in utero exposures, or those in early childhood, are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolescence and adulthood is also linked to the development of testicular cancer. Of these, two adult occupational exposures-fire fighting and aircraft maintenance--and one environmental exposure (to organochlorine pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, seven of the identified factors--diet, types of physical activity, military service, police work as well as exposure to ionizing radiation, electricity and acrylamide--are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures--to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use--require further study to determine their association with testicular cancer.
在过去几十年中,许多发达国家的睾丸癌发病率一直在上升。发病率上升的原因尚不清楚,因为这种疾病的风险因素还没有被很好地理解。一些研究表明,子宫内暴露或儿童早期暴露可能在决定个体的风险水平方面起着重要作用。然而,其他研究表明,青春期和成年期接触各种因素也与睾丸癌的发生有关。在这些因素中,两种成人职业暴露(消防和飞机维修)和一种环境暴露(有机氯农药)可能与睾丸癌发病风险增加有关。相比之下,已确定的 7 个因素(饮食、体力活动类型、兵役、警察工作以及接触电离辐射、电和丙烯酰胺)不太可能增加患睾丸癌的风险。最后,还有另外 7 个暴露因素(热、聚氯乙烯、非电离辐射、重金属、农业劳动、农药和多氯联苯以及大麻使用)需要进一步研究,以确定它们与睾丸癌的关联。