Study finds link between neurodevelopmental disorders and risk of testicular cancer in men

Sweden: A recent study published in the British Journal of Cancer has shown an association between neurodevelopmental disorders, such as autism and ADHD and the risk of testicular cancer or seminoma in men. Testicular cancer is the most common cancer in young men, and its underlying causes are still largely unknown.

In general, the researchers at Uppsala University and Uppsala University Hospital did not find an increased risk of testicular cancer in patients with a psychiatric diagnosis. Still, the group with a neurodevelopmental disorder saw a significant increase in the risk of the seminoma type of testicular cancer.

Although the researchers found an increased risk of seminoma among people with neurodevelopmental disorders, the absolute risk increase was less than one percent. The risk of testicular cancer is, therefore, still very low even among boys and men with conditions such as autism and ADHD, and there is no need to worry if you have these diagnoses. However, the results are intriguing in terms of attempts to get closer to explaining the mechanisms of testicular cancer occurrence.

“As testicular cancer can be surgically removed, thus curing the disease, it is important to seek care in time if you feel a lump in your testicle,” notes Ingrid Glimelius, Senior Consultant at the Department of Oncology at Uppsala University Hospital and Professor at Uppsala University.

The new study focused on patients with testicular cancer in Sweden. A total of 6,166 patients were included and then compared with 61,660 age-matched men without testicular cancer. Medical register data was used to investigate whether psychiatric diagnoses before cancer diagnosis were more common in patients with testicular cancer than in the control group.

“The study also found that people with a neurodevelopmental disorder were a median of four years younger when they developed cancer and were more likely to have more advanced disease at diagnosis,” adds Glimelius.

"We also saw that people with a previous psychiatric diagnosis had a slightly increased risk of dying from their testicular cancer compared to people without a previous psychiatric diagnosis, although testicular cancer survival rates were generally very good in both groups," says Anna Jansson, doctoral student at Uppsala University and Physician at Uppsala University Hospital.

This is the first research study to provide a link between neurodevelopmental disorders and the risk of testicular cancer. Previously known risk factors include having an undescended testicle as a baby or having a father or brother with testicular cancer.

“We do not know why we are seeing a link between neurodevelopmental disorders and the risk of testicular cancer, but we believe that early life events have an impact; perhaps even as early as the foetal stage,” continues Jansson.

“Since we can see a reduced survival rate among people with a mental health issue, it is important for the health care system, the individuals in question and their families to be aware that they may also be affected by another illness, and to ensure they seek treatment if they feel a lump in their testicle. This disease can be cured in most people today,” adds Glimelius.

FACTS: Testicular cancer

* In Sweden, approximately 360 men are diagnosed with testicular cancer each year, and testicular cancer is the most common cancer among young men aged 15–35.

* The most common symptom of testicular cancer is feeling a lump in the testicle.

* The specific cause of testicular cancer is unknown. Still, some risk factors have been identified, such as the fact that around 10% of those affected have had surgery for an undescended testicle in childhood and that a hereditary predisposition is noted in around 1–3% of those affected. The risk is deemed most severe if you have a brother with testicular cancer.

* Treatment involves surgery to remove the diseased testicle. The disease can also be cured if it has spread beyond the testicle through chemotherapy, making testicular cancer one of the most survivable cancers today.

Reference:

Jansson, A.K., Söderling, J., Reutfors, J. et al. Risk and mortality of testicular cancer in patients with neurodevelopmental or other psychiatric disorders. Br J Cancer (2023). https://doi.org/10.1038/s41416-023-02260-8.