Maternal body mass index and risk of testicular cancer in male offspring: a systematic review and meta-analysis.
OBJECTIVE
To date a number of studies have examined the association between maternal weight and testicular cancer risk although results have been largely inconsistent. This systematic review and meta-analysis investigated the nature of this association.


METHODS
Search strategies were conducted in Ovid Medline (1950-2009), Embase (1980-2009), Web of Science (1970-2009), and CINAHL (1937-2009) using keywords for maternal weight (BMI) and testicular cancer.


RESULTS
The literature search produced 1689 hits from which 63 papers were extracted. Only 7 studies met the pre-defined criteria. Random effects meta-analyses were conducted. The combined unadjusted OR (95% CI) of testicular cancer in the highest reported category of maternal BMI compared with the moderate maternal BMI was 0.82 (0.65-1.02). The Cochran's Q P value was 0.82 and the corresponding I(2) was 0%, both indicating very little variability among studies. The combined unadjusted OR (95% CI) for testicular cancer risk in the lowest reported category of maternal BMI compared to a moderate maternal BMI category was 0.88 (0.65-1.20). The Cochran's Q P value was 0.05 and the corresponding I(2) was 54%, indicating evidence of statistical heterogeneity. The combined unadjusted OR (95% CI) of testicular cancer risk per unit increase in maternal BMI was 1.01 (0.97-1.06). The Cochran's Q test had a P value of 0.05 and the corresponding I(2) was 55% indicating evidence of statistical heterogeneity.


CONCLUSIONS
This meta-analysis, which included a small number of studies, showed that a higher maternal weight does not increase the risk of testicular cancer in male offspring. Though an inverse association between high maternal BMI and testicular cancer risk was detected, it was not statistically significant. Further primary studies with adjustment for appropriate confounders are required.
Alam
Shama S
SS
Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom. salam01@qub.ac.uk
Cantwell
Marie M
MM
Cardwell
Chris R
CR
Cook
Michael B
MB
Murray
Liam J
LJ
D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008429:Maternal Welfare; D011247:Pregnancy; D013736:Testicular Neoplasms / Q000453:epidemiology*
Cancer Causes Control. 1992 May;3(3):265-72
1610973
Br J Cancer. 1996 Mar;73(5):698-701
8605110
Hum Reprod. 2001 May;16(5):972-8
11331648
Lancet. 1993 May 29;341(8857):1392-5
8098802
Hinyokika Kiyo. 1988 May;34(5):832-8
3177126
Cancer Epidemiol Biomarkers Prev. 2003 Jul;12(7):669-73
12869410
Cancer Causes Control. 2004 Apr;15(3):277-83
15090722
Cancer Causes Control. 1997 Nov;8(6):904-12
9427433
Br J Cancer. 2004 Apr 5;90(7):1367-73
15054456
J Natl Cancer Inst. 1983 Dec;71(6):1151-5
6140323
Public Health Nutr. 2001 Apr;4(2B):611-24
11683554
Int J Cancer. 2004 May 10;109(6):941-4
15027129
Lancet Oncol. 2004 Jun;5(6):363-71
15172357
Int J Cancer. 2008 Sep 15;123(6):1480
18561320
Br J Cancer. 1998 Apr;77(7):1180-5
9569059
Stat Med. 2002 Jun 15;21(11):1539-58
12111919
Pain. 2000 Apr;85(3):415-424
10781914
Cancer. 2005 Mar 1;103(5):1064-71
15685619
Am J Epidemiol. 1986 Jul;124(1):39-52
2872797
Oncol Res. 2007;16(8):383-7
17913046
Int J Gynaecol Obstet. 1995 Mar;48(3):269-72
7781868
Cancer Res. 1986 Sep;46(9):4812-6
3731127
Cancer Epidemiol Biomarkers Prev. 2003 Jul;12(7):643-6
12869404
Int J Obes Relat Metab Disord. 1992 Sep;16(9):627-31
1328085
Cancer Epidemiol Biomarkers Prev. 2006 Apr;15(4):652-8
16614105
Int J Cancer. 2009 Feb 15;124(4):952-7
19035442
Int J Cancer. 2007 Sep 1;121(5):1123-31
17471572
Pediatr Res. 2008 Jan;63(1):99-102
18043501
Cancer Causes Control. 1990 Sep;1(2):119-24
2102281
Am J Clin Nutr. 2007 Oct;86(4):907-13
17921364
Cancer Causes Control. 1998 Oct;9(5):475-86
9934714
BMJ. 1997 May 24;314(7093):1507-11
9169396
J Urol. 1987 Nov;138(5):1214-6
2889833
Br J Cancer. 1999 Jun;80(7):1098-102
10362123
Epidemiology. 2007 Mar;18(2):220-5
17202869
J Natl Cancer Inst. 1986 Jun;76(6):1035-9
3458941
Lancet. 2006 Mar 4;367(9512):754-65
16517276
N Engl J Med. 1997 Jul 24;337(4):242-53
9227931
Int J Cancer. 1998 Oct 5;78(2):140-3
9754641
APMIS. 2003 Jan;111(1):280-9
12752274
BMJ. 1997 Sep 13;315(7109):629-34
9310563
Am J Clin Nutr. 2002 Jun;75(6):1072-7
12036815
Am J Epidemiol. 1992 Jun 1;135(11):1301-9
1626547
Int J Cancer. 1996 May 3;66(3):287-93
8621244
Am J Obstet Gynecol. 2001 Oct;185(4):845-9
11641663
Br J Cancer. 1995 Feb;71(2):416-20
7841064
Scand J Urol Nephrol Suppl. 2000;(205):166-86
11144894
Int J Cancer. 2008 Feb 15;122(4):957; author reply 958-9
17943727
Reprod Toxicol. 2006 Jan;21(1):4-15
16005180
Obstet Gynecol. 2004 Oct;104(4):720-6
15458892
Jpn J Clin Oncol. 1990 Mar;20(1):72-7
2319701
Int J Androl. 2003 Feb;26(1):2-15
12534932
Int J Cancer. 1979 May 15;23(5):598-602
37169
Lancet. 1997 Dec 13;350(9093):1723-8
9413462
Cancer Causes Control. 2009 Nov;20(9):1587-92
19636804
Cancer Res. 2008 Nov 1;68(21):8832-6
18974126
Int J Cancer. 2000 Aug 1;87(3):438-43
10897052