Maternal smoking during pregnancy and testicular cancer in the sons: A nested case–control study and a meta-analysis

Tuomisto, Jouko; Holl, Katsiaryna; Rantakokko, Panu; Koskela, Pentti; Hallmans, Göran; Wadell, Göran; Stattin, Pär; Dillner, Joakim; Ögmundsdottir, Helga M.; Vartiainen, Terttu; Lehtinen, Matti; Pukkala, Eero

doi:10.1016/j.ejca.2009.01.017

« Previous Next »European Journal of Cancer
Volume 45, Issue 9 , Pages 1640-1648, June 2009

Maternal smoking during pregnancy and testicular cancer in the sons: A nested case–control study and a meta-analysis

Jouko Tuomisto
- Department of Environmental Health, THL (National Institute for Health and Welfare, Formerly National Public Health Institute), P. O. Box 95, FI-70701 Kuopio, Finland
- Corresponding author: Tel.: +358 40 5866761; fax: +358 17 201265.
Katsiaryna Holl
- Department of Child and Adolescent Health, National Institute for Health and Welfare, Oulu, Finland
- Tampere School of Public Health, University of Tampere, Tampere, Finland
Panu Rantakokko
- Department of Environmental Health, THL (National Institute for Health and Welfare, Formerly National Public Health Institute), P. O. Box 95, FI-70701 Kuopio, Finland
Pentti Koskela
- Department of Child and Adolescent Health, National Institute for Health and Welfare, Oulu, Finland
Göran Hallmans
- Department of Public Health and Clinical Medicine/Nutritional Research, University of Umeå, Umeå, Sweden
Göran Wadell
- Department of Virology, University of Umeå, Umeå, Sweden
Pär Stattin
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Sweden
Joakim Dillner
- Department of Medical Microbiology, University of Lund, Malmö, Sweden
Helga M. Ögmundsdottir
- Icelandic Cancer Society, Reykjavik, Iceland
- Molecular and Cell Biology Research Laboratory, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Terttu Vartiainen
- Department of Environmental Health, THL (National Institute for Health and Welfare, Formerly National Public Health Institute), P. O. Box 95, FI-70701 Kuopio, Finland
- Department of Environmental Sciences, University of Kuopio, Kuopio, Finland
Matti Lehtinen
- Tampere School of Public Health, University of Tampere, Tampere, Finland
Eero Pukkala
- Tampere School of Public Health, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland

Received 14 November 2008; received in revised form 12 January 2009; accepted 15 January 2009. published online 24 February 2009.

Abstract

Some large ecological studies have noted a significant association of testicular cancer (TC) with maternal smoking during pregnancy, while several more controlled studies have been negative. It has been difficult to obtain reliable data on exposure because of the long lag time to cancer diagnosis. We performed a case–control study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of maternal smoking in the risk of TC in the offspring. After reviewing the literature, we also performed a meta-analysis of published studies. For each index mother of the TC patient, three to nine matched control mothers with a cancer-free son born at the same time as the TC case were identified within each cohort. First trimester sera were retrieved from the 70 index mothers and 519 control mothers and were tested for cotinine level by a novel HPLC–MS–MS method developed. No statistically significant association between maternal cotinine level and risk of TC in the offspring was found (OR 0.68; 95% CI 0.35, 1.34). This is the first study based on individual exposure measurements. Its results agree with our meta-analysis of seven previous epidemiological studies (total number of 2149 cases, 2762 controls) using indirect exposure assessment (OR 1.0; 95% CI 0.88, 1.12).

Keywords: Maternal smoking, Cotinine, Cotinine analysis, Testicular cancer, Offspring, Developmental effects, Pregnancy