The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because the risk factors for the disease are poorly understood. Some research suggests that in utero exposures, or those in early childhood, are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolescence and adulthood is also linked to the development of testicular cancer. Of these, two adult occupational exposures-fire fighting and aircraft maintenance--and one environmental exposure (to organochlorine pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, seven of the identified factors--diet, types of physical activity, military service, police work as well as exposure to ionizing radiation, electricity and acrylamide--are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures--to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use--require further study to determine their association with testicular cancer.

Adolescent and adult risk factors for testicular cancer

Background 
Oil and gas development emits known hematological carcinogens, such as benzene, and increasingly occurs in residential areas. We explored whether residential proximity to oil and gas development was associated with risk for hematologic cancers using a registry-based case-control study design.


Methods 
Participants were 0–24 years old, living in rural Colorado, and diagnosed with cancer between 2001–2013. For each child in our study, we calculated inverse distance weighted (IDW) oil and gas well counts within a 16.1-kilometer radius of residence at cancer diagnosis for each year in a 10 year latency period to estimate density of oil and gas development. Logistic regression, adjusted for age, race, gender, income, and elevation was used to estimate associations across IDW well count tertiles for 87 acute lymphocytic leukemia (ALL) cases and 50 non-Hodgkin lymphoma (NHL) cases, compared to 528 controls with non-hematologic cancers.


Findings 
Overall, ALL cases 0–24 years old were more likely to live in the highest IDW well count tertiles compared to controls, but findings differed substantially by age. For ages 5–24, ALL cases were 4.3 times as likely to live in the highest tertile, compared to controls (95% CI: 1.1 to 16), with a monotonic increase in risk across tertiles (trend p-value = 0.035). Further adjustment for year of diagnosis increased the association. No association was found between ALL for children aged 0–4 years or NHL and IDW well counts. While our study benefited from the ability to select cases and controls from the same population, use of cancer-controls, the limited number of ALL and NHL cases, and aggregation of ages into five year ranges, may have biased our associations toward the null. In addition, absence of information on O&G well activities, meteorology, and topography likely reduced temporal and spatial specificity in IDW well counts.


Conclusion 
Because oil and gas development has potential to expose a large population to known hematologic carcinogens, further study is clearly needed to substantiate both our positive and negative findings. Future studies should incorporate information on oil and gas development activities and production levels, as well as levels of specific pollutants of interest (e.g. benzene) near homes, schools, and day care centers; provide age-specific residential histories; compare cases to controls without cancer; and address other potential confounders, and environmental stressors.

/pdf/childhood-hematologic-cancer-and-residential-proximity-to-1v01pn2yyy.pdf

Childhood hematologic cancer and residential proximity to oil and gas development

Viruses and human cancer.

The male genital tract (MGT) is the target of a number of viral infections that can have deleterious consequences at the individual, offspring and population levels. These consequences include infertility, cancers of male organs, transmission to the embryo/fetal development abnormalities and sexual dissemination of major viral pathogens such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Lately, two emerging viruses, Zika and Ebola, have additionally revealed that the human MGT can constitute a reservoir for viruses cleared from peripheral circulation by the immune system, leading to their sexual transmission by cured men. This represents a concern for future epidemics and further underlines the need for a better understanding of the interplay between viruses and the MGT. We review here how viruses, from ancient viruses that integrated the germ line during evolution through old viruses (e.g. papillomaviruses originating from Neanderthals) and more modern sexually-transmitted infections (e.g. simian zoonotic HIV) to emerging viruses (e.g. Ebola and Zika) take advantage of genital tract colonization for horizontal dissemination, viral persistence, vertical transmission and endogenization. The MGT immune responses to viruses and the impact of these infections are discussed. We summarize the latest data regarding the sources of viruses in semen and the complex role of this body fluid in sexual transmission. Finally, we introduce key animal findings that are relevant for our understanding of viral infection and persistence in the human MGT and suggest future research directions.

/pdf/from-ancient-to-emerging-infections-the-odyssey-of-viruses-35wq74mhsb.pdf

From Ancient to Emerging Infections: The Odyssey of Viruses in the Male Genital Tract.

Object Intraoperative CT image–guided navigation (IGN) has been increasingly incorporated into minimally invasive spine surgery (MIS) The vast improvement in image resolution and virtual real-time images with CT-IGN has proven superiority over traditional fluoroscopic techniques The authors describe their perioperative MIS technique using the O-arm with navigation, and they report their postoperative experience, accuracy results, and technical aspects Methods A retrospective review of 48 consecutive adult patients undergoing minimally invasive percutaneous posterior spinal fusion with intraoperative CT-IGN between July 2010 and August 2013 at Cedars-Sinai Medical Center was performed Two surgeons assessed 290 screws in a blinded fashion on intraoperative O-arm images and postoperative CT scans for bony pedicle wall breach Grade 1 breach was defined to be 4 mm Additionally, anterior vertebral body breach was recorded Resul

/pdf/clinical-and-radiographic-outcomes-of-minimally-invasive-4necxcki87.pdf

Clinical and radiographic outcomes of minimally invasive percutaneous pedicle screw placement with intraoperative CT (O-arm) image guidance navigation.

Testicular cancer is a rare disease, affecting mainly young men aged 15-49. There have been some recent reports that it might be associated with radiation exposure. We have systematically reviewed this topic. English-language articles published between 1990 and 2008 studying the relationship between occupational radiation exposure and testicular cancer were included. Risk of bias was assessed using a modified version of the EPHPP checklist. For ionising radiation we subdivided study populations into occupational groups. No pooled analysis was performed due to the heterogeneity of studies. Seven case-control and 30 cohort studies were included in the review. For radiation workers, one incidence study showed a significant increase and four showed no effect. Eight mortality studies did not indicate an effect while four showed a non-significant increase. Incidence among persons with military exposure was not increased in two studies and non-significantly increased in another two. Among aircrew studies, one showed no effect against five with slight increases. Medical exposure studies showed no increases. For EMF exposure, three studies showed no effect, two reported a significant and four a non-significant increase in incidence. Overall, there was very limited evidence for associations between occupational ionising radiation and testicular cancer, while there were some positive associations for EMF. Testicular cancer mortality is generally low and was not associated with radiation. New incidence studies are recommended to investigate the association between radiation exposure and testicular cancer where exposure is better specified and individually estimated.

Testicular cancer risk associated with occupational radiation exposure: a systematic literature review

In 1984, Newell and coworkers were the first to suggest that testicular cancer might have a viral etiology since it showed similar characteristics to Hodgkin's lymphoma. A systematic literature review and meta-analysis was conducted to investigate a possible association between viral infections (EBV, CMV, Parvovirus B19, HPV, and HIV) and testicular cancer. Articles published from 1985 through June 2010 were located from MEDLINE and EMBASE databases, 21 articles were finally included in the review. For infection with EBV, CMV, Parvovirus B19, and HIV the pooled OR were 4.80 (95% CI 0.98–23.54), 1.85 (95% CI 0.92–3.70), 2.86 (95% CI 0.35–23.17), and 1.79 (95% CI 1.45–2.21) respectively. No pooling was possible for HPV infection studies due to small numbers. The results support a possible association, but more epidemiological studies with better viral identification and localization methods are needed to verify these findings. J. Med. Virol. 85:2165–2175, 2013. © 2013 Wiley Periodicals, Inc.

Testicular cancer and viral infections: a systematic literature review and meta-analysis.

Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany.

Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as 564 suitable controls (from a pool of other cancers) were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR) and associated 95% confidence intervals (CI).

Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63) and for clerical support workers (OR 1.71, 95% CI 1.14–2.56). This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33) and clerks (OR 2.00, 95% CI 1.30–3.09), respectively. An association with testicular cancer was observed for no other occupation.

Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach.

Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate-Germany.

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Testicular cancer risk associated with occupational radiation exposure: a systematic literature review

Testicular cancer and viral infections: a systematic literature review and meta-analysis.

Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate-Germany.