gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Etiologic differences between seminoma and nonseminoma of the testis: a systematic review of epidemiological studies

Meeting Abstract

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  • Andreas Stang - Universität Halle, Halle
  • Oliver Kuß - Universität Halle, Halle

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds344

doi: 10.3205/11gmds344, urn:nbn:de:0183-11gmds3449

Published: September 20, 2011

© 2011 Stang et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: Several descriptive epidemiological features of testicular cancer suggest that the etiologies of seminoma and nonseminoma of the testis may differ. To address this, we conducted a systematic review of case-control and cohort studies of the etiology of testicular cancer.

Methods: We conducted a detailed literature search and identified 150 eligible studies. We calculated ratios of relative risk (RR) estimates (RoRR: RR of seminoma divided by RR of nonseminoma) and corresponding 95% confidence intervals (95%CI).

Results: Overall 61 and 12 publications of case-control studies and cohort studies respectively reported stratified RR estimates by histologic group. The year of publication was positively associated with stratification by histologic subgroup. We extracted a total of 1,148 RR estimates, stratified by histologic subgroup, reflecting 631 exposures. Ratios of RR estimates were symmetrically distributed, with a peak at the reference value of one. The symmetry of the funnel plot suggests lack of publication bias. The corresponding p-value distribution was very close to the expected distribution under the null hypothesis of no histologic heterogeneity in the RR estimates.

Discussion: Our results do not provide evidence in support of the hypothesis that seminoma and nonseminoma have different etiologies or risk factors among adolescents and young men differ. To date, only descriptive epidemiologic features, such as the incidence age patterns and incidence time trends of seminoma and nonseminoma of the testis, have provided evidence suggesting different etiologies, especially among newborns, infants, and elderly men.