ESMO 2022: Risk and Mortality of Testicular Cancer in Patients with Psychiatric or Neurodevelopmental Disorders

( During the Mini Oral session of the European Society for Medical Oncology (ESMO) Annual Congress focusing on non-prostate genitourinary cancers, Dr. Jansson presented a population-based analysis assessing the association between psychiatric disorders, in particular neurodevelopmental disorders, and the risk of testicular germ cell cancer (TGCC), as well as mortality.


To do this, the authors performed a nested case-control study including 6,250 patients with TGCC who were diagnosed between 1992-2014, individually matched to 62,500 controls. They used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between history of psychiatric diagnoses and TGCC risk.


Among patients with TGCC, the authors used a cohort study design and Cox regression to calculate hazard ratios (HRs) with 95% CIs of the association between psychiatric diagnosis and all-cause and TGCC-specific mortality.

In the case-control study design, for both patients with seminoma and those with non-seminoma, a history of cryptorchidism was more common among men with testis cancer.

The authors found that a history of a neurodevelopmental disorder (i.e., attention deficit hyperactivity disorder, autism spectrum disorder, and intellectual disabilities) was associated with an increased risk of seminoma (OR 1.54; 95% CI 1.09-2.19). Additionally, seminoma patients with neurodevelopmental disorders were younger (34 versus 38 years, p=0.004) and more often presented with stage IV disease (5.4% versus 1.2%, p=0.04) than those without such a history. Interestingly, patients with psychotic disorders were found to have a decreased risk of seminoma (OR 0.62; 95% CI 0.40-0.96). Taken overall, the authors found that psychiatric history overall was not associated with TGCC.

In spite of this, patients with a history of any psychiatric disorder had an increased all-cause mortality (HR 2.91; 95% CI 2.11-4.02) and an increased TGCC-specific mortality (HR 1.79; 95% CI 1.04-3.08). There was an increase in cause-specific mortality for both non-seminoma and seminoma among men with a history of psychiatric diagnoses.


Thus, Dr. Jansson concluded that this presentation represents the first identification of this novel association between neurodevelopmental disorders and testicular seminoma.

Presented by: Anna K. Jansson, PhD student at Department of Immunology, Genetics and Pathology, Cancer Precision Medicine; Research group Ingrid Glimelius, Uppsala, Sweden

Written by: Christopher J.D. Wallis, University of Toronto Twitter: @WallisCJD during the 2022 European Society for Medical Oncology (ESMO) Annual Congress, 9-13 September 2022.