title: Endogenous steroid hormone levels in early pregnancy and risk of testicular cancer in the offspring: a nested case-referent study.
abstract: According to the leading hypothesis on testicular cancer (TC) etiology exposure to a specific pattern of steroid hormones in utero, in particular, to high levels of estrogens and low levels of androgens is the major determinant of TC risk in the offspring. We performed a case-referent study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of maternal endogenous steroid hormones with regard to the risk of TC. TC cases and referents were aged between 0 and 25 years. For each case-index mother pair, three or four matched referent-referent mother pairs were identified using national population registries. First trimester or early second trimester sera were retrieved from the index mothers of 73 TC cases and 286 matched referent mothers, and were tested for dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG). Offspring of mothers with high DHEAS levels had a significantly decreased risk of TC (OR for highest vs. lowest DHEAS quartile, 0.18 (95% CI 0.06-0.58). In contrast, offspring of mothers with high androstenedione levels had an increased risk of TC (OR 4.1; 95% CI 1.2-12.0). High maternal total estradiol level also tended to be associated with an increased risk of TC in the offspring (OR 32; 95% CI 0.98-1,090). We report the first direct evidence that interplay of maternal steroid hormones in the early pregnancy is important in the etiology of TC in the offspring.
authors.affiliation: Department of Child and Adolescent Health, National Institute for Health and Welfare, Oulu, Finland. katsiaryna.holl@gmx.com
authors.forename: Katsiaryna
authors.initials: K
authors.lastname: Holl
authors.forename: Eva
authors.initials: E
authors.lastname: Lundin
authors.forename: Heljä-Marja
authors.initials: HM
authors.lastname: Surcel
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Pentti
authors.initials: P
authors.lastname: Koskela
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Göran
authors.initials: G
authors.lastname: Wadell
authors.forename: Gudridur H
authors.initials: GH
authors.lastname: Olafsdottir
authors.forename: Helga M
authors.initials: HM
authors.lastname: Ogmundsdottir
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.forename: Matti
authors.initials: M
authors.lastname: Lehtinen
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova