Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy.
Medical Oncology Division 1, University Hospital "Citta' della Salute e della Scienza", Turin, Italy.
Int J Cancer. 2017 Nov 1;141(9):1803-1810. doi: 10.1002/ijc.30884. Epub 2017 Jul 27.
Testicular cancer is considered to originate from an impaired differentiation of fetal germ cells, but puberty could represent another time window of susceptibility. Our study aimed at investigating the association between environmental exposures acting during puberty/adolescence (13-19 years of age) and the risk of testicular cancer. We used data of the EPSAM study, a case-control study on germ-cell testicular cancer conducted in the province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Histologically confirmed cases (n = 255) and controls (n = 459) completed a postal questionnaire focusing in particular on the pubertal period (namely age 13 years) with questions on physical activity (competitive sports, gardening), lifestyle (alcohol consumption, smoking), occupational history and medical conditions. All analyses were adjusted for the matching variables, cryptorchidism and educational level. Having done at least one competitive sport during puberty (odds ratio [OR]: 0.72, 95% confidence interval: 0.52-1.00), gardening activities during puberty (OR: 0.62, 0.42-0.94) and having a lower weight than peers during puberty (OR: 0.64, 0.42-0.97) were all inversely associated with the risk of testicular cancer. No evidence of association between smoking or alcohol consumption during puberty and the risk of testicular cancer was observed. Regarding agriculture-related occupations, we found an association with the risk of testicular cancer both for occasional jobs during puberty (OR: 2.40, 95% CI: 1.08-5.29) and ever employment in adolescence (OR: 2.59, 95% CI: 0.83-8.10). Our results suggest that postnatal exposures could play a role in testicular cancer aetiology, at least when acting in puberty or adolescence.
睾丸癌被认为起源于胎儿生殖细胞的分化障碍，但青春期可能是另一个易感性时期。我们的研究旨在调查青春期/青少年时期（13-19 岁）暴露于环境因素与睾丸癌风险之间的关联。我们使用了意大利都灵省进行的一项关于生殖细胞睾丸癌的病例对照研究（EPSAM 研究）的数据，该研究纳入了 1997 年至 2008 年间诊断的病例（n=255）和对照组（n=459）。病例和对照组均完成了一份重点关注青春期（即 13 岁）的邮寄问卷，其中包括有关体育活动（竞技运动、园艺）、生活方式（饮酒、吸烟）、职业史和健康状况的问题。所有分析均根据匹配变量、隐睾和教育程度进行了调整。在青春期至少进行过一次竞技运动（比值比 [OR]：0.72，95%置信区间：0.52-1.00）、青春期园艺活动（OR：0.62，0.42-0.94）和青春期体重低于同龄人（OR：0.64，0.42-0.97）与睾丸癌风险呈负相关。未发现青春期吸烟或饮酒与睾丸癌风险之间存在关联。关于与农业相关的职业，我们发现青春期偶尔从事农业工作（OR：2.40，95%CI：1.08-5.29）和青少年时期一直从事农业工作（OR：2.59，95%CI：0.83-8.10）与睾丸癌风险之间存在关联。我们的研究结果表明，出生后暴露可能在睾丸癌发病机制中发挥作用，至少在青春期或青少年时期发挥作用。
