title: Testicular germ cell tumours and parental occupational exposure to pesticides: a register-based case-control study in the Nordic countries (NORD-TEST study).
abstract: OBJECTIVE
  A potential impact of exposure to endocrine disruptors, including pesticides, during intrauterine life, has been hypothesised in testicular germ cell tumour (TGCT) aetiology, but exposure assessment is challenging. This large-scale registry-based case-control study aimed to investigate the association between parental occupational exposure to pesticides and TGCT risk in their sons.
  
  
  METHODS
  Cases born in 1960 or onwards, aged between 14 and 49 years, and diagnosed between 1978 and 2013 in Denmark, Finland, Norway or Sweden, were identified from the respective nationwide cancer registries. Four controls per case were randomly selected from the general national populations, matched on year of birth. Information on parental occupation was collected through censuses or Pension Fund information and converted into a pesticide exposure index based on the Finnish National Job-Exposure Matrix.
  
  
  RESULTS
  A total of 9569 cases and 32,028 controls were included. No overall associations were found for either maternal or paternal exposures and TGCT risk in their sons, with ORs of 0.83 (95% CI 0.56 to 1.23) and of 1.03 (0.92 to 1.14), respectively. Country-specific estimates and stratification by birth cohorts revealed some heterogeneity. Cryptorchidism, hypospadias and family history of testicular cancer were risk factors but adjustment did not change the main results.
  
  
  CONCLUSIONS
  This is the largest study on prenatal exposure to pesticides and TGCT risk, overall providing no evidence of an association. Limitations to assess individual exposure in registry-based studies might have contributed to the null result.
authors: Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France Unité Cancer et Environnement, Centre Léon Bérard, Lyon, France.
authors: Charlotte
authors: C
authors: Le Cornet
authors: Unité Cancer et Environnement, Centre Léon Bérard, Lyon, France Université Claude Bernard-Lyon 1, Villeurbanne, France.
authors: Béatrice
authors: B
authors: Fervers
authors: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Susanne Oksbjerg
authors: SO
authors: Dalton
authors: The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Maria
authors: M
authors: Feychting
authors: Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland School of Health Sciences, University of Tampere, Tampere, Finland.
authors: Eero
authors: E
authors: Pukkala
authors: Kreftregisteret, Cancer Registry of Norway, Oslo, Norway National Institute of Occupational Health, Oslo, Norway.
authors: Tore
authors: T
authors: Tynes
authors: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Johnni
authors: J
authors: Hansen
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Karl-Christian
authors: KC
authors: Nordby
authors: Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France Unité Cancer et Environnement, Centre Léon Bérard, Lyon, France Université Claude Bernard-Lyon 1, Villeurbanne, France.
authors: Rémi
authors: R
authors: Béranger
authors: Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
authors: Timo
authors: T
authors: Kauppinen
authors: Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
authors: Sanni
authors: S
authors: Uuksulainen
authors: The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Pernilla
authors: P
authors: Wiebert
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Torill
authors: T
authors: Woldbæk
authors: University Department of Growth and Reproduction, University Hospital of Copenhagen, Copenhagen, Denmark.
authors: Niels E
authors: NE
authors: Skakkebæk
authors: Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Ann
authors: A
authors: Olsson
authors: Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France.
authors: Joachim
authors: J
authors: Schüz
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003456:Cryptorchidism / Q000150:complications; D052244:Endocrine Disruptors / Q000009:adverse effects; D005260:Female; D006801:Humans; D007021:Hypospadias / Q000150:complications; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010290:Parents; D018812:Paternal Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries; D013736:Testicular Neoplasms / Q000209:etiology*; D055815:Young Adult
chemical_list: D052244:Endocrine Disruptors; D010575:Pesticides