Table of ContentsView AllTable of ContentsGeneticsCommon FactorsLifestyle Risk FactorsMyths and MisconceptionsFrequently Asked QuestionsNext in Testicular Cancer GuideWhat Is Testicular Cancer?
Table of ContentsView All
View All
Table of Contents
Genetics
Common Factors
Lifestyle Risk Factors
Myths and Misconceptions
Frequently Asked Questions
Next in Testicular Cancer Guide
While we have yet to unlock the secrets of whytesticular canceroccurs, scientists believe that a combination of genetic, physiological, and environmental factors is involved. In recent years, no less than 19 chromosomal mutations have been linked to testicular cancers. Younger age, race, an undescended testicle, and testicular development problems are also commonly associated with the disease.
Other risk factors—including horseback riding, competition cycling, smoking, weight, and vasectomy—have long been presumed to either cause or contribute to testicular cancer but are not proven to have any association with the condition.
This article explores the causes and risk factors for testicular cancer.
Testicular canceris an uncommon cancer affecting just over 9,000 American men each year.
There are several different types of testicular cancer. The vast majority are classified as germ cell cancers. These are malignancies that arise from the cells that produce spermatozoa (immature sperm).
TypesBroadly speaking, there are two types of germ cell cancer:Seminomasare a type that grows and spreads relatively slowly and primarily affects men between ages 25 and 45.Non-seminomastypically affect men in their late-teens to early-30s. Non-seminomas are often aggressive and more likely to spread (metastasize).
Types
Broadly speaking, there are two types of germ cell cancer:Seminomasare a type that grows and spreads relatively slowly and primarily affects men between ages 25 and 45.Non-seminomastypically affect men in their late-teens to early-30s. Non-seminomas are often aggressive and more likely to spread (metastasize).
Broadly speaking, there are two types of germ cell cancer:
Germ cell cancers have specific genetic alterations. Under normal circumstances, the cells of our body have two sets of 23 chromosomes—one set from each biological parent. Some cells in germ cell cancers may have three sets of chromosomes (triploid) and even four (tetraploid).
A characteristic genetic alteration that almost all germ cell cancers share is an extra copy of a fragment of chromosome 12 (isochromosome 12p), a chromosomal anomaly associated with both testicular and ovarian cancers.
More than with other types of cancer, these mutations run in families. In fact, according to scientists from the Institute of Cancer Research in London, the rate of inheritability of testicular cancer is 48.9%. That’s a striking figure given that genetics usually accounts for less than 20% of the risk with other forms of cancer.
By and large, the most common risk factors for testicular cancer are non-modifiable, meaning that you are either born with them or cannot change them. Some risk factors are related to lifestyle.
Age
Age plays a major role in testicular cancer risk insofar as the disease mostly affects men between the ages of 15 and 35.While the disease is rare before puberty or after age 50, it does sometimes occur at those ages.
According to the American Cancer Society, the average age at the time of testicular cancer diagnosis is 33. Only around 6% of cases involve young boys or teens, while 8% occur in men over 55.
Race and Ethnicity
Statistically, White men have a four-fold greater risk of testicular cancer than either Black or Asian men.Hispanic men have only slightly less risk than White men. Native American men, meanwhile, have a risk between Whites and Blacks.
Globally, the risk of testicular cancer is highest among men in the United States and Europe and lowest among men living in Asia and Africa.
Undescended Testicle (Cryptorchidism)
While the association is poorly understood, it is believed that the disruption of spermatogenesis (the development of spermatozoa from germ cells) may trigger genetic changes that increase the risk of testicular cancer.
Men who have had cryptorchidism have an eight-fold increased risk of testicular cancer.Moreover, men with a partially descended testicle are less likely to develop cancer than men with a testicle that remains in their abdomen.
Testicular cancer oratrophy(which can be associated with lower testosterone production or lower fertility) will usually, but not always, affect the undescended testicle.
Carcinoma in Situ
Carcinoma in situ (CIS)is an abnormal growth of tissue often referred to as precancer, although not all cases of CIS will become malignant.
According to a 2015 study published in theAnnals of Oncology, men diagnosed with testicular CIS have at least a 50% risk of developing testicular cancer over the course of five years.
Despite the increased likelihood of malignancy, there remains considerable controversy as to whether doctors should preemptively treat CIS to prevent it from turning cancerous. To date, there is no consensus as to when testicular CIS should be treated or what level of radiation treatment is appropriate.
As such, most doctors will take a watch-and-wait approach rather than expose a man to potentially unnecessary radiation or surgery.
Testicular Microlithiasis
Calcium deposits in the testicles, known as testicular microlithiasis, is seen in around 20% of men who have difficulty conceiving. While microlithiasis on its own is not associated with testicular cancer, in men with testicular CIS, the risk of developing a malignancy will increase.
Other Possible Causes
Among them:
Early puberty, long presumed to be a risk factor, has been shown to have no effect on a man’s personal risk of testicular cancer.
Lifestyle factors can have a minimal effect on testicular cancer risk, but they haven’t been found to play a significant role.
Smoking
While smoking is associated with at least 16 types of cancer—including those affecting the lungs, mouth, throat, bladder, kidneys, pancreas, stomach, liver, bowel, cervix, and ovaries—its role in testicular cancer is far less clear.
This shouldn’t suggest that smoking is “safe” —quitting cigarettes can drastically cut your risk of other health problems besides testicular cancer.
Marijuana
Marijuana may be a risk factor for testicular cancer.
According to the research, exposure to delta-9-tetrahydrocannabinol (THC), the psychoactive chemical in cannabis, can disrupt spermatogenesis in the same way that an undescended testicle can.
Obesity
Being overweight neither increases your risk of testicular cancer nor your chance of relapsing after treatment.
This shouldn’t suggest that putting on a few extra pounds is a good thing. In fact, if you are overweight and undergotesticular cancer treatment, your risk of cardiovascular risk may skyrocket. This is because testicular cancer treatment will often result in hypogonadism (low testosterone production), a condition closely associated withmetabolic syndrome.
When former Tour de France cyclistLance Armstongwas diagnosed with testicular cancer in 1996, it was largely presumed that years of riding on a bicycle saddle was to blame. It is a misperception that persists to this day, suggesting that repetitive actions such as cycling, horseback riding, or motorcycling are major contributors, if not the primary cause, of testicular cancer.
This is untrue. Years of research has yet to reveal any link between these or any other strenuous physical activities and the risk of testicular cancer.
What Doesn’t Cause Testicular CancerYou cannot get testicular cancer as a result of:Testicular injuryVasectomyWearing tight pantsCarrying a cell phone in your pocketA urinary tract infectionAn enlarged prostate
What Doesn’t Cause Testicular Cancer
You cannot get testicular cancer as a result of:Testicular injuryVasectomyWearing tight pantsCarrying a cell phone in your pocketA urinary tract infectionAn enlarged prostate
You cannot get testicular cancer as a result of:
Current evidence suggests that having had testicular cancer can increase a man’s risk of intermediate- to high-risk prostate cancer at least fivefold, suggesting a greater need for post-treatment surveillance.
However, prostate cancer does not increase testicular cancer risk.
Common early signs of testicular cancer include a lump or swelling in the testicles, a heavy feeling in the scrotum, and pain in the scrotum. The best way to find a lump at an early stage is to perform regularself examinations.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Facts About Testicular Cancer: Testicular Cancer Statistics.Litchfield, K.; Thomson, H.; Mitchell, J. et al.Quantifying the heritability of testicular germ cell tumour using both population-based and genomic approaches.Scientific Reports.2015; 5:13889. DOI:10.1038/srep13889.National Cancer Institute.Familial testicular cancer.Light DE, Leslie SW.Testicular Seminoma. StatPearls Publishing LLC.American Cancer Society.Facts about testicular cancer: Testicular cancer statistics.American Cancer Society.Testicular Cancer Risk Factors: Risks For Testicular Cancer.Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Van hemelrijck M.Global incidence and outcome of testicular cancer. Clin Epidemiol. 2013;5:417-27. doi:10.2147/CLEP.S34430Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O.Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835-41. doi:10.1056/NEJMoa067588Kier, M.; Lauritson, J.; Almstrup, K. et al.Screening for carcinomain situin the contralateral testicle in patients with testicular cancer: a population-based study.Annal Oncology.2015; 26(4):737-42. DOI:10.1093/annonc/mdu585.Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH.Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-32. doi:10.1002/cncr.25231Goedert JJ, Purdue MP, Mcneel TS, Mcglynn KA, Engels EA.Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1266-9. doi:10.1158/1055-9965.EPI-07-0042Accardo, G.; Vallone, G.; Esposito, D. et al.Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients.Asian J Androl.2015; 17(1):154-8. DOI:10.4103/1008-682X.128514.Lerro, A.; McGlynn, K.; and Cook, M.A systematic review and meta-analysis of the relationship between body size and testicular cancer.Brit J Cancer.2010; 103:1467-74. DOI:10.1039/sj.bjc.6605934.Srivastava A, Kreiger N.Cigarette smoking and testicular cancer. Cancer Epidemiol Biomarkers Prev. 2004;13(1):49-54. doi:10.1158/1055-9965.EPI-03-0133Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI:10.1186/s12885-015-1905-6Gurney J, Shaw C, Stanley J, Signal V, Sarfati D.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897. doi:10.1186/s12885-015-1905-6Huang S, Signal V, Sarfati D, et al.Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18(1):189. doi:10.1186/s12885-018-4093-3Riggin AJ, Siddiqui MM.Development of intermediate and high-risk prostate cancer after testicular cancer. Journal of Clinical Oncology. 2015;33(7_suppl):177-177. doi:10.1200/jco.2015.33.7_suppl.177American Cancer Society.Signs and symptoms of testicular cancer.American Cancer Society.Testicular cancer survival rates.Additional ReadingRiggins, A. and Siddiqui, M.Development of intermediate and high-risk prostate cancer after testicular cancer.J Clin Oncology. 2015; 33(Suppl 7):177. DOI: 10.1200/jco.2015:33.7_suppl.177.Akers, O.; Ekbom, A.; Sparen, P. et al.Body Size and Testicular Cancer.J Nat Cancer Institute.2000; 92(13): 1093-96. DOI: 10.1093/jnci/92.13.1093.Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI: 10.1186/s12885-015-1905-6.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Facts About Testicular Cancer: Testicular Cancer Statistics.Litchfield, K.; Thomson, H.; Mitchell, J. et al.Quantifying the heritability of testicular germ cell tumour using both population-based and genomic approaches.Scientific Reports.2015; 5:13889. DOI:10.1038/srep13889.National Cancer Institute.Familial testicular cancer.Light DE, Leslie SW.Testicular Seminoma. StatPearls Publishing LLC.American Cancer Society.Facts about testicular cancer: Testicular cancer statistics.American Cancer Society.Testicular Cancer Risk Factors: Risks For Testicular Cancer.Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Van hemelrijck M.Global incidence and outcome of testicular cancer. Clin Epidemiol. 2013;5:417-27. doi:10.2147/CLEP.S34430Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O.Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835-41. doi:10.1056/NEJMoa067588Kier, M.; Lauritson, J.; Almstrup, K. et al.Screening for carcinomain situin the contralateral testicle in patients with testicular cancer: a population-based study.Annal Oncology.2015; 26(4):737-42. DOI:10.1093/annonc/mdu585.Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH.Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-32. doi:10.1002/cncr.25231Goedert JJ, Purdue MP, Mcneel TS, Mcglynn KA, Engels EA.Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1266-9. doi:10.1158/1055-9965.EPI-07-0042Accardo, G.; Vallone, G.; Esposito, D. et al.Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients.Asian J Androl.2015; 17(1):154-8. DOI:10.4103/1008-682X.128514.Lerro, A.; McGlynn, K.; and Cook, M.A systematic review and meta-analysis of the relationship between body size and testicular cancer.Brit J Cancer.2010; 103:1467-74. DOI:10.1039/sj.bjc.6605934.Srivastava A, Kreiger N.Cigarette smoking and testicular cancer. Cancer Epidemiol Biomarkers Prev. 2004;13(1):49-54. doi:10.1158/1055-9965.EPI-03-0133Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI:10.1186/s12885-015-1905-6Gurney J, Shaw C, Stanley J, Signal V, Sarfati D.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897. doi:10.1186/s12885-015-1905-6Huang S, Signal V, Sarfati D, et al.Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18(1):189. doi:10.1186/s12885-018-4093-3Riggin AJ, Siddiqui MM.Development of intermediate and high-risk prostate cancer after testicular cancer. Journal of Clinical Oncology. 2015;33(7_suppl):177-177. doi:10.1200/jco.2015.33.7_suppl.177American Cancer Society.Signs and symptoms of testicular cancer.American Cancer Society.Testicular cancer survival rates.Additional ReadingRiggins, A. and Siddiqui, M.Development of intermediate and high-risk prostate cancer after testicular cancer.J Clin Oncology. 2015; 33(Suppl 7):177. DOI: 10.1200/jco.2015:33.7_suppl.177.Akers, O.; Ekbom, A.; Sparen, P. et al.Body Size and Testicular Cancer.J Nat Cancer Institute.2000; 92(13): 1093-96. DOI: 10.1093/jnci/92.13.1093.Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI: 10.1186/s12885-015-1905-6.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Facts About Testicular Cancer: Testicular Cancer Statistics.Litchfield, K.; Thomson, H.; Mitchell, J. et al.Quantifying the heritability of testicular germ cell tumour using both population-based and genomic approaches.Scientific Reports.2015; 5:13889. DOI:10.1038/srep13889.National Cancer Institute.Familial testicular cancer.Light DE, Leslie SW.Testicular Seminoma. StatPearls Publishing LLC.American Cancer Society.Facts about testicular cancer: Testicular cancer statistics.American Cancer Society.Testicular Cancer Risk Factors: Risks For Testicular Cancer.Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Van hemelrijck M.Global incidence and outcome of testicular cancer. Clin Epidemiol. 2013;5:417-27. doi:10.2147/CLEP.S34430Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O.Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835-41. doi:10.1056/NEJMoa067588Kier, M.; Lauritson, J.; Almstrup, K. et al.Screening for carcinomain situin the contralateral testicle in patients with testicular cancer: a population-based study.Annal Oncology.2015; 26(4):737-42. DOI:10.1093/annonc/mdu585.Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH.Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-32. doi:10.1002/cncr.25231Goedert JJ, Purdue MP, Mcneel TS, Mcglynn KA, Engels EA.Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1266-9. doi:10.1158/1055-9965.EPI-07-0042Accardo, G.; Vallone, G.; Esposito, D. et al.Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients.Asian J Androl.2015; 17(1):154-8. DOI:10.4103/1008-682X.128514.Lerro, A.; McGlynn, K.; and Cook, M.A systematic review and meta-analysis of the relationship between body size and testicular cancer.Brit J Cancer.2010; 103:1467-74. DOI:10.1039/sj.bjc.6605934.Srivastava A, Kreiger N.Cigarette smoking and testicular cancer. Cancer Epidemiol Biomarkers Prev. 2004;13(1):49-54. doi:10.1158/1055-9965.EPI-03-0133Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI:10.1186/s12885-015-1905-6Gurney J, Shaw C, Stanley J, Signal V, Sarfati D.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897. doi:10.1186/s12885-015-1905-6Huang S, Signal V, Sarfati D, et al.Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18(1):189. doi:10.1186/s12885-018-4093-3Riggin AJ, Siddiqui MM.Development of intermediate and high-risk prostate cancer after testicular cancer. Journal of Clinical Oncology. 2015;33(7_suppl):177-177. doi:10.1200/jco.2015.33.7_suppl.177American Cancer Society.Signs and symptoms of testicular cancer.American Cancer Society.Testicular cancer survival rates.
American Cancer Society.Facts About Testicular Cancer: Testicular Cancer Statistics.
Litchfield, K.; Thomson, H.; Mitchell, J. et al.Quantifying the heritability of testicular germ cell tumour using both population-based and genomic approaches.Scientific Reports.2015; 5:13889. DOI:10.1038/srep13889.
National Cancer Institute.Familial testicular cancer.
Light DE, Leslie SW.Testicular Seminoma. StatPearls Publishing LLC.
American Cancer Society.Facts about testicular cancer: Testicular cancer statistics.
American Cancer Society.Testicular Cancer Risk Factors: Risks For Testicular Cancer.
Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Van hemelrijck M.Global incidence and outcome of testicular cancer. Clin Epidemiol. 2013;5:417-27. doi:10.2147/CLEP.S34430
Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O.Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835-41. doi:10.1056/NEJMoa067588
Kier, M.; Lauritson, J.; Almstrup, K. et al.Screening for carcinomain situin the contralateral testicle in patients with testicular cancer: a population-based study.Annal Oncology.2015; 26(4):737-42. DOI:10.1093/annonc/mdu585.
Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH.Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-32. doi:10.1002/cncr.25231
Goedert JJ, Purdue MP, Mcneel TS, Mcglynn KA, Engels EA.Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1266-9. doi:10.1158/1055-9965.EPI-07-0042
Accardo, G.; Vallone, G.; Esposito, D. et al.Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients.Asian J Androl.2015; 17(1):154-8. DOI:10.4103/1008-682X.128514.
Lerro, A.; McGlynn, K.; and Cook, M.A systematic review and meta-analysis of the relationship between body size and testicular cancer.Brit J Cancer.2010; 103:1467-74. DOI:10.1039/sj.bjc.6605934.
Srivastava A, Kreiger N.Cigarette smoking and testicular cancer. Cancer Epidemiol Biomarkers Prev. 2004;13(1):49-54. doi:10.1158/1055-9965.EPI-03-0133
Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI:10.1186/s12885-015-1905-6
Gurney J, Shaw C, Stanley J, Signal V, Sarfati D.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897. doi:10.1186/s12885-015-1905-6
Huang S, Signal V, Sarfati D, et al.Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18(1):189. doi:10.1186/s12885-018-4093-3
Riggin AJ, Siddiqui MM.Development of intermediate and high-risk prostate cancer after testicular cancer. Journal of Clinical Oncology. 2015;33(7_suppl):177-177. doi:10.1200/jco.2015.33.7_suppl.177
American Cancer Society.Signs and symptoms of testicular cancer.
American Cancer Society.Testicular cancer survival rates.
Riggins, A. and Siddiqui, M.Development of intermediate and high-risk prostate cancer after testicular cancer.J Clin Oncology. 2015; 33(Suppl 7):177. DOI: 10.1200/jco.2015:33.7_suppl.177.Akers, O.; Ekbom, A.; Sparen, P. et al.Body Size and Testicular Cancer.J Nat Cancer Institute.2000; 92(13): 1093-96. DOI: 10.1093/jnci/92.13.1093.Gurney, J.; Shaw, C.; Stanley, J. et al.Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis.BMC Cancer.2015; 15:897. DOI: 10.1186/s12885-015-1905-6.
Riggins, A. and Siddiqui, M.Development of intermediate and high-risk prostate cancer after testicular cancer.J Clin Oncology. 2015; 33(Suppl 7):177. DOI: 10.1200/jco.2015:33.7_suppl.177.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
