Testicular cancer risk factors: who is more likely to get it

What testicular cancer is

Testicular cancer is a disease in which cancer cells form in the tissues of one or both testicles. The testicles are two egg-shaped glands inside the scrotum that make testosterone and sperm. Almost all testicular cancers start in the germ cells, the cells that make immature sperm. The two main types are seminomas and nonseminomas, which grow, spread and are treated differently (NCI).

Testicular cancer is very rare (MedlinePlus). The number of new cases has doubled in the last 40 years, but deaths have gone down greatly because of better treatment, and it can usually be cured, even in late stages (NCI).

Risk factors

A risk factor is anything that raises your chance of getting a disease. NCI lists these risk factors for testicular cancer (NCI):

• An undescended testicle (cryptorchidism). MedlinePlus describes this as one or both testicles not moving into the scrotum before birth (MedlinePlus).
• A testicle that is not normal, such as a small testicle that does not work the way it should (NCI). MedlinePlus words this as having had abnormal testicle development (MedlinePlus).
• Testicular carcinoma in situ (NCI).
• Being White (NCI) (MedlinePlus).
• A personal or family history of testicular cancer (NCI) (MedlinePlus).
• Klinefelter syndrome (NCI).

Men who have an undescended testicle, a testicle that is not normal, or testicular carcinoma in situ have a higher risk of cancer in one or both testicles and need to be followed closely (NCI).

Not everyone with one or more of these risk factors gets testicular cancer, and it does develop in people with no known risk factors. NCI advises talking with your doctor if you think you may be at risk (NCI).

Risk by age and group

You can get testicular cancer at any age, but it is most common between ages 20 and 39 (MedlinePlus). NCI says it is the most common cancer in men aged 20 to 39, with the highest rates between ages 25 and 34 (NCI).

The racial and ethnic groups with the highest rates are non-Hispanic White men, non-Hispanic American Indian men and Alaska Native men (NCI).

Signs to check with a doctor

These signs can be caused by testicular cancer or by other conditions. Check with your doctor if you have any of them (NCI) (MedlinePlus):

• a painless lump or swelling in either testicle
• a change in how the testicle feels
• a dull ache in the lower belly or the groin
• a sudden build-up of fluid in the scrotum
• pain or discomfort in a testicle or in the scrotum

To check for testicular cancer, a provider may use a physical exam, blood tests and an ultrasound of the testicles (MedlinePlus).

Routine screening of men without symptoms is a separate question; the testicular cancer screening check covers what the USPSTF says about it.

Common questions

Does smoking raise testicular cancer risk?

Smoking is not on NCI's list of testicular cancer risk factors, and MedlinePlus does not list it either (NCI) (MedlinePlus). If you smoke and want to stop, the quit smoking help check covers the help available.

Is testicular cancer genetic?

A family history of testicular cancer is a risk factor, and so is Klinefelter syndrome (NCI). Most of the other listed risk factors, such as an undescended or abnormal testicle, are about how the testicles formed (NCI) (MedlinePlus).

If I had testicular cancer before, can it happen in the other testicle?

Yes. Men who have had testicular cancer have a higher risk of cancer in the other testicle. NCI advises checking the other testicle regularly and reporting any unusual symptoms to a doctor right away (NCI).

Which risk factors can I change?

None of the risk factors NCI lists can be changed: they are about how the testicles formed, family and personal history, genes and race (NCI). What you can do is know the signs above and see a doctor about any change.

Also see prostate cancer risk factors, which cancer check fits you and screening tests by age.