Globally, testicular cancer incidence is highest among men of northern European ancestry and lowest among men of Asian and African descent. Incidence rates have been increasing around the world for at least 50 years, but mortality rates, at least in developed countries, have been declining. While reasons for the decreases in mortality are related to improvements in therapeutic regimes introduced in the late 1970s, reasons for the increase in incidence are less well understood. An accumulating body of evidence suggests, however, that testicular cancer arises in fetal life. Perinatal factors, including exposure to endocrine disrupting chemicals, have been suggested to be related to risk.
Keywords testicular germ cell tumor; seminoma; nonseminoma; perinatal etiologyAlthough a rare cancer in the general population, testicular cancer is the most common malignancy among young men in many countries. Approximately 98% of testicular cancers are germ cell tumors (TGCT). The remaining 2% include stromal tumors such as Leydig cell (~0.2%) and Sertoli cell tumors (~0.1%), as well as other more rare or poorly defined histologic types. Among TGCTs, approximately 55% are classic seminomas, 44% are nonseminomas (embryonal carcinomas, teratomas, yolk sac tumors, choriocarcinomas) and 1% are spermatocytic seminomas.