Is risk of testicular cancer related to body size?

Background and Objectives: The incidence of testicular germ cell tumors (GCT) has been increasing since decades but cohorts of men born during war-time and immediately thereafter had a lower incidence. Based on this epidemiological observation, a hypothesis was generated that postulated nutritional factors in early life to be involved in the pathogenesis of GCT. To support this hypothesis biomarkers for early life nutrition were analyzed. Patients and Methods: In a case control study, 353 prospectively enrolled patients with GCT and 259 hospital-based controls with bone fractures and with nephrolithiasis were assessed for adult height, weight and body mass index (BMI). All of the patients and controls were aged between 15 and 45 years. Evaluation was done by descriptive tabulation of data, by calculating univariate odds-ratios for potential risk factors, by calculating p-values for trend-tests and by multivariate logistic regression analysis. In addition, the literature was surveyed with respect to the suspected association of anthropometric measures with GCT-risk. Results: No significant associations were found with respect to BMI and weight. However, height was significantly associated with GCT-risk (p < 0.001). The multivariate analysis strengthened this association showing an increased risk of GCT with an odds-ratio of 2.11 (95% confidence interval 1.25; 3.55) for body height of at least 185 cm when compared to base-line height of 175-179 cm. Eleven previous studies with data on body size and GCT-risk were found in the literature. Conclusion: Tallness appears to be significantly associated with risk of germ cell cancer. As adult height is a proxy for energy intake during early life it is probable that the pathogenesis of GCT is promoted by childhood nutrition. It is conceivable that the increase in GCT incidence and the secular trend of increasing adult stature are interrelated. Increasing availability and increasing awareness of protein-rich food in early childhood could be the common denominator to these observations. (C) 2002 Elsevier Science B.V. All rights reserved.