ETIOLOGY OF TESTICULAR CANCER - ASSOCIATION WITH CONGENITAL-ABNORMALITIES, AGE AT PUBERTY, INFERTILITY, AND EXERCISE
ETIOLOGY OF TESTICULAR CANCER - ASSOCIATION WITH CONGENITAL-ABNORMALITIES, AGE AT PUBERTY, INFERTILITY, AND EXERCISE
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DOI：
10.1136/bmj.308.6941.1393
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发表时间：
1994-05-28
影响因子：
--
通讯作者：
REID, S
中科院分区：
文献类型：
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作者：
FORMAN, D;PIKE, MC;REID, S
目的：探讨与隐睾、腹股沟疝、青春期年龄、婚姻状况、不育、输精管结扎和运动量相关的睾丸癌风险。设计-一项基于人群的病例对照研究，问卷由采访者管理，相关补充数据摘自全科医生的记录。环境-英格兰和威尔士的9个卫生区域。受试者：794名男性，年龄15-49岁，1984年1月1日至1987年1月1日诊断为睾丸生殖细胞瘤；每个人都从他们的全科医生名单中选择了一个年龄匹配（一年内）的对照。结果：睾丸癌与隐睾（比值比3.82；95%可信区间2.24 ~ 6.52）和腹股沟疝（比值比1.91；95%可信区间1.12 ~ 3.23）有显著相关性。在10岁之前接受过睾丸切除术的男性中，与睾丸隐睾相关的额外风险被消除了。早破嗓、早刮胡子和不孕之间存在正相关。这与久坐不动的生活方式和适度的运动保护作用有显著的联系。与输精管结扎术无关。结论：本研究证实了先前的报道，即发育性泌尿生殖系统异常会导致睾丸癌的风险增加。在较年轻的年龄进行睾丸切除术的趋势可能会降低与隐睾相关的风险。过早进入青春期和运动量不足会增加患乳腺癌的风险，这可能与接触内源性激素有关。这两种因素的变化可能在一定程度上导致了过去几十年来睾丸癌发病率的上升。
Objective-To determine the risk of testicular cancer associated with undescended testis, inguinal hernia, age at puberty, marital status, infertility, vasectomy, and amount of exercise.Design-A population based case-control study with a questionnaire administered by an interviewer and with relevant supplementary data extracted from general practitioners' notes.Setting-Nine health regions within England and Wales.Subjects-794 men, aged 15-49 years, with a testicular germ cell tumour diagnosed between 1 January 1984 and 1 January 1987; each had an age matched (within one year) control selected from the list of their general practitioner.Results-There was a significant association of testicular cancer with undescended testis (odds ratio 3.82; 95% confidence interval 2.24 to 6.52) and inguinal hernia (1.91; 1.12 to 3.23). The excess risk associated with undescended testis was eliminated in men who had had an orchidopexy before the age of 10 years. There were positive associations with early age at voice breaking, early age at starting to shave, and infertility. There was a significant association with a sedentary lifestyle and a moderate protective effect of exercise. There was no association with vasectomy.Conclusion-This study confirms previous reports that developmental urogenital abnormalities result in an increased risk of testicular cancer. The trend to perform orchidopexy at younger ages may reduce the risk associated with undescended testis. The increased risks associated with early age at puberty and low amounts of exercise may be related to effects of exposure to endogenous hormones. Changes in both of these factors may partly contribute to the increasing rates of testicular cancer observed in the past few decades.