Abstract Background Testicular germ cell tumors (TGCT) are thought to be endocrine-related. The hypothesis, however, has not been thoroughly investigated. As a result, pre-diagnostic serum samples from the U.S. Servicemen’s Testicular Tumor Environmental and Endocrine Determinants (STEED) were analyzed to assess the relationship of hormones and gonadotropins to TGCT risk. Methods The study included 517 men who subsequently developed TGCT and 790 comparison men. The hormones/gonadotropins examined included testosterone, estradiol, sex-hormone binding globulin (SHBG), 5α-androstane-3α,17β-diol glucuronide (3α-diol G), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Analyses stratified by histology (seminoma, nonseminoma) were also conducted. Results Compared to men in the middle quintile of LH concentrations, men with the lowest concentrations had an increased risk of TGCT (OR 1.88, 95% CI 1.31-2.70), as did men with FSH concentrations in the lowest (OR 1.77, 95% CI 1.21-2.60) and highest quintiles (OR 2.20, 95% CI 1.53-3.17). An increased risk of seminoma was found with both low and high LH, and high FSH, while an increased risk of nonseminoma was found with low LH, and both low and high FSH. Decreased levels of 3α-diol G were associated with increased risk of seminoma (OR 1.65, 95%CI 1.02-2.67). Conclusion These results suggest that gonadotropin disruption may be a critical event in the development of TGCT. Further examination of upstream and downstream metabolites in the hormone pathways may help elucidate the underlying mechanism that distinguishes men who develop TGCT from men who do not.
Wu et al. (Wed,) studied this question.