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Doctors can't usually say that any one thing caused your cancer. Instead, they talk about risk factors. Risk factors aren't causes of a disease exactly. But if you have a particular risk factor for a disease, your chance of getting the disease is higher.

Even if some of these things apply to you, they don't mean you'll definitely get testicular cancer. It's a rare condition, and even with several of these risk factors, your overall chance of getting it may still be very low.

The main risk factors for testicular cancer are:^{1 2}

• Being between 30 and 39
• Having a testicle that didn't descend properly when you were a baby
• Your ethnic group (white men are more likely to get testicular cancer than men from other groups).

Testicular cancer is very rare before puberty.¹ But after going through puberty, younger men are more likely to get testicular cancer than older men. It's most common in men around 30, and very rare in anyone over 60.¹

In the United States, testicular cancer is most common in white men between about 30 and 34. For black men, it's most common in men aged between 35 and 39. And for Hispanic men, it's most common in men aged between 25 and 29.³

But the overall number of men who get it is still fairly low. Each year in the United States:³

• Between 3 in 30,000 and 6 in 30,000 white men get testicular cancer between the ages of 30 and 34.
• About 3 in 30,000 Hispanic men get testicular cancer between the ages of 25 and 29.
• About 1 in 30,000 black men get testicular cancer between the ages of 35 and 39.

Remember, these numbers say how likely you are to get testicular cancer at the age when your risk is highest. Your overall risk will be much lower. For more information, see How common is testicular cancer?

Testicular cancers are divided into seminomas and non-seminomas depending on what the cancer cells look like under a microscope. You're more likely to get a kind of testicular cancer called seminoma between the ages of 35 and 40.¹ You're more likely to get a non-seminoma from around 25 to 30. (For more information about types of testicular cancer, see What is testicular cancer?)

When a male baby is growing in the womb, its testicles are inside its body. But as the baby grows, the testicles move downward. When the baby is born, the testicles are normally outside the body, in the scrotum.

In some boys, the testicles stay inside the body. This can happen to one or both testicles. A testicle that doesn't descend normally can cause problems later. It may not be able to grow properly or make sperm. Boys with this problem will usually have an operation to move the testicle into their scrotum.

Having an undescended testicle, or having had an operation to cure one, can mean you have a higher risk of getting testicular cancer.^{1 2} Having an operation to cure an undescended testicle at a younger age may reduce the risk.¹

Some studies have shown that having an abdominal hernia may increase your risk of testicular cancer. An abdominal hernia happens when a piece of your bowel pokes out through a weak spot in the muscles of your abdomen. But it may just be that hernias are more common in men who've had a testicle that didn't descend properly.

Testicular cancer is more common among white men than black or Asian men.^{1 4 5} One study in the United States found that about 5 in 100,000 white men got testicular cancer. This compared with only 1 in 100,000 black men.¹

Below are some more things that might affect your chances of getting testicular cancer.^{1 2 4}

• Your hormones. Testicular cancer hardly ever affects boys before puberty. So, the hormones your body starts making at this time may play a part in causing testicular cancer. Going through puberty at a young age may increase your risk.
• The conditions in your mother's womb. High amounts of the hormone estrogen in your mother's body when you were in the womb may affect your risk of testicular cancer. Lots of things in the environment can affect the conditions in your mother's womb. And if your mother smoked while she was pregnant, this may also increase your risk.
• Conditions that affect your testicles. Medical conditions that mean your testicles don't grow properly as you get older may increase your risk of testicular cancer. If your testicles don't develop properly, it's called gonadal dysgenesis. Having a condition called Klinefelter's syndrome may also increase your risk. Klinefelter's syndrome is a condition you're born with. It can mean your testicles don't grow properly.
• Birth weight. Being a low weight or a high weight when you're born may increase your risk.
• Your job. Aircraft mechanics, men who work with petrol or metal, and men who work for printing and leather companies are all more likely to get testicular cancer. This is probably because of the chemicals you're more likely to come in contact with if you do these jobs.
• Your genes. An increased risk of testicular cancer may run in families. Your risk is higher if your father or brother have had testicular cancer. The risk may also come from the fact that people from the same family usually grow up in a similar environment.
• The food you eat. Some studies suggest that eating lots of fatty foods, milk and cheese may increase your risk. Not eating enough fruit and vegetables may also mean you have a higher risk.
• An infection. Some doctors think an infection with a virus could play a part in causing testicular cancer. Having mumps can cause inflammation of the testicles, and some studies show this may increase your risk. Men with HIV or AIDS also have a higher risk. This may be because AIDS damages your body's ability to fight infections.

Men who have trouble fathering children are more likely to be diagnosed with testicular cancer.² However, it's probably not true to say that fertility problems in men help to cause testicular cancer.² It might just be that fertility problems and testicular cancer are caused by similar things. Or having testicular cancer could damage your sperm and make it harder to have children.

Some studies suggest that a blow or injury to your testicles may increase your risk of testicular cancer.¹ But it may just be that you're more likely to examine your testicles after a blow. So, you may spot a lump that you hadn't noticed before.

Having had testicular cancer before can increase your chance of getting it again in your other testicle. But it's rare for testicular cancer to come back after treatment, especially if you're treated early.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.