Increased Concentrations of Polychlorinated Biphenyls, Hexachlorobenzene, and Chlordanes in Mothers of Men with Testicular Cancer. (Environmental Medicine: Article)
Hardell, Lennart, van Bavel, Bert, Lindstrom, Gunilla, Carlberg, Michael, Dreifaldt, Ann Charlotte, Wijkstrom, Hans, Starkhammar, Hans, Eriksson, Mikael, Hallquist, Arne, Kolmert, Torgny, Environmental Health Perspectives
An increasing incidence of testicular cancer has been reported from several countries in the Western world during the last decades. According to current hypothesis, testicular cancer is initiated during the fetal period, and exposure to endocrine disruptors, i.e., xenoestrogens, has been of concern. In this investigation we studied the concentrations of the sum of 38 polychlorinated biphenyls (PCBs), p,p'-dichlorodiphenyl-dichloroethylene, hexachlorobenzene (HCB), and chlordanes, in 61 cases with testicular cancer and 58 age-matched controls. Furthermore, case and control mothers were also asked to participate, and 44 case mothers and 45 control mothers agreed. They were of similar age. In cases only the concentration on lipid basis of cis-nonachlordane was significantly increased, whereas case mothers showed significantly increased concentrations of the sum of PCBs, HCB, trans- and cis-nonachlordane, and the sum of chlordanes. Among case mothers the sum of PCBs yielded an odds ratio (OR) of 3.8; 95% confidence interval (CI), 1.4-10 was calculated using the median concentration for the control mothers as cutoff value. For HCB, OR = 4.4 (95% CI, 1.7-12); for trans-nonachlordane, OR = 4.1 (95% CI, 1.5-11); for cis-nonachlordane, OR = 3.1 (95% CI, 1.2-7.8); and for sum of chlordanes, OR = 1.9 (95% CI, 0.7-5.0). No consistent different risk pattern was found for seminoma or nonseminoma testicular cancer. Key words: chlordanes, fetal period, hexachlorobenzene, persistent organic pollutants, polychlorinated biphenyls, testicular cancer.
An increasing incidence of testicular cancer has been reported from several western countries during the last decades (Toppari et al. 1995, 1996). In Sweden the annual age-adjusted incidence of testicular cancer increased significantly by 2.2% from 1980 to 1999 (National Board of Health and Welfare 2001). It is the most common cancer among young males. Testicular cancer has usually not been regarded as an occupational disease (Hardell et al. 1998), but cryptorchidism is an established risk factor. An increased risk has also been reported for the contralateral descendent testis (Henderson et al. 1979), suggesting common risk factors. Some prenatal risk factors seem to be common for both cryptorchidism and testicular cancer, such as high levels of estrogen in the first trimester (Bernstein et al. 1988; Cosgrove et al. 1977).
Prenatal exposures have been suggested to be of etiologic significance, such as environmental pollutants with estrogen potency, i.e., xenoestrogens (Toppari et al. 1995, 1996). In this context the so-called estrogen hypothesis has been expanded to include environmental antiandrogens as endocrine disruptors with potential adverse effects on male reproductive health (Skakkebaek et al. 2001; Toppari et al. 1996). Impacts of increasing levels of xenoestrogens have been observed in aquatic systems (Colborn et al. 1993). In humans, concern has been focused on endocrine-disrupting chemicals with either estrogenic or antiestrogenic effects, which may be related to an increasing incidence of hypospadia in newborn boys (Dolk 1998; Paulozzi 1999). Indications of a decrease in sperm counts have been observed in recent years, but the hypothesis of an association with exposure to xenoestrogens is still a controversial question (Jensen et al. 1995).
Our aim in this study was to investigate concentrations of certain persistent organic pollutants (POPs) in blood from men with testicular cancer compared with controls, and in mothers to cases compared with mothers to controls. Informed consent was obtained from all study persons. The study was approved by all involved ethical committees.
Materials and Methods
Incident cases with testicular cancer were recruited from 1997 to 2000 from the Department of Urology at Huddinge (n = 17) and Karolinska Hospital in Stockholm (n = 5), and the Departments of Oncology at the University Hospitals in Orebro (n = 13), Linkoping (n = 13), and Lund (n = 10), Sweden. …