Testicular germ cell tumour risk by occupation and industry: a French case–control study – TESTIS

Abstract

ObjectiveTesticular germ cell tumours (TGCT) are the most common cancer in men of working age and its incidence has increased notably over the past 40 years. Several occupations have been identified as potentially associated with TGCT risk. The aim of this study was to further explore the relationship between occupations, industries and TGCT risk in men aged 18–45 years.MethodsThe TESTIS study is a multicenter case–control study conducted between January 2015 and April 2018 in 20 of 23 university hospital centers in metropolitan France. A total of 454 TGCT cases and 670 controls were included. Full job histories were collected. Occupations were coded according to the International Standard Classification of Occupation 1968 version (ISCO-1968) and industry according to the 1999 version of Nomenclature d’Activités Française (NAF-1999). For each job held, ORs and 95% CIs were estimated using conditional logistic regression.ResultsA positive association was observed between TGCT and occupation as agricultural, animal husbandry worker (ISCO: 6–2; OR 1.71; 95% CI (1.02 to 2.82)), as well as salesman (ISCO: 4–51; OR 1.84; 95% CI (1.20 to 2.82)). An increased risk was further observed among electrical fitters and related, electrical and electronics workers employed for 2 years or more (ISCO: 8–5; OR≥2 years1.83; 95% CI (1.01 to 3.32)). Analyses by industry supported these findings.ConclusionsOur findings suggest that agricultural, electrical and electronics workers, and salesmen workers experience an increased risk of TGCT. Further research is needed to identify the agents or chemicals in these high-risk occupations which are relevant in the TGCT development.Trial registration numberNCT02109926.

Parental occupations at birth and risk of adult testicular germ cell tumors in offspring: a French nationwide case–control study

“…Here, the risk of developing TGCT in adulthood was increased when the father had a job as specialized farmer (particularly seminomas) or worked in crops (all histological subtypes in sensitivity analysis from data reported by mothers), suggesting a possible link between perinatal pesticide exposure and TGCT risk, while our results across farming-related jobs seemed inconsistent. Among sons, an increased risk of developing TGCT was observed in the TESTIS population in association with having personally worked as a farmer, which appears to be consistent with our results ( 65 ). Moreover, many pesticides, such as organochlorines, have endocrine disruptive properties ( 75 ), which have been suggested to be implicated in the development of testicular dysgenesis syndrome and TGCT ( 15 , 75 ).…”

“…To observe the relationship between parental jobs at birth and TGCT in offspring, the use of two nomenclatures based on job and industry categories and subcategories appeared complementary but involved multiple analyses. This limitation has been previously discussed (65). Although our results may be interpreted with caution, overall they appear to be consistent with the literature.…”

“…Some of these parental occupations at birth have previously been suspected to be related to the development of TGCT in children and adults (42), as well as prenatal exposure to solvents (63,64), particularly seminomas (44). Among sons, an increased risk of developing TGCT was observed in the TESTIS population in association with some occupations that could be related to solvent exposures (subjects employed in the trade, motor vehicle repair, and household goods industries), which may support the hypothesis of a link between TGCT and occupational exposure to solvents (65). However, some studies do not show the risk increases described in our study, for example among protective service workers (66).…”

The increasing burden of testicular seminomas and non-seminomas in adolescents and young adults (AYAs): incidence, treatment, disease-specific survival and mortality trends in the Netherlands between 1989 and 2019

“…retail, supermarket, non-specialty stores) workers was also observed in a recent paper from the TESTIS study group in France, reaffirming that exposure to occupational-related agents and chemicals are likely involved in disease development. 33 Despite growing research on testicular cancer aetiology, a comprehensive understanding of the underlying causes and molecular mechanisms (e.g. exposure time to endocrine disruptors and genetic background) is still lacking, 21 , 32 , 34 hampering large-scale preventative measures to stabilize the increasing incidence, such as legislation to decrease endocrine-disrupting chemicals in the environment or screening for individuals at risk for developing testicular cancer.…”