What Are the Risk Factors for Testicular Cancer?

Last updated and reviewed on June 28, 2026.

A risk factor is anything that raises the likelihood that a person will develop a particular disease. Having a risk factor does not mean you will definitely develop testicular cancer, and many men who are diagnosed with it have no known risk factors at all. At the same time, understanding the known risk factors helps doctors identify men who may benefit from closer attention and helps researchers continue working toward better prevention and early detection strategies.

Testicular cancer is unusual in that its risk factors are relatively few and well-defined, but several of them, including an undescended testicle and a family history of the disease, are strong enough to genuinely matter. Many of the known risk factors cannot be changed, but being aware of them is still useful.

What Raises Your Risk for Developing Testicular Cancer?

• Cryptorchidism (undescended testicle): An undescended testicle is one of the strongest known risk factors for testicular cancer. During normal fetal development, the testicles form inside the abdomen and then descend through a canal in the groin into the scrotum, usually before birth or within the first year of life. When this process does not happen, and a testicle remains inside the abdomen or gets stuck in the groin canal, it is called cryptorchidism.
• Men with a history of cryptorchidism: Have roughly 3 to 5 times the average risk of developing testicular cancer, even if the undescended testicle was surgically moved into the scrotum (a procedure called orchiopexy). The testicle that did not descend normally carries most of the elevated risk, but the normally descended testicle also has a somewhat higher risk than average, suggesting that whatever causes abnormal descent may also affect the germ cells more broadly. Men with a history of undescended testicles should discuss their history with a doctor and be aware of the signs and symptoms to watch for.
• Personal history of testicular cancer: Having had testicular cancer in one testicle is one of the strongest predictors of developing it in the other. Men who have been treated for testicular cancer in one testicle have approximately a 2 to 5 percent lifetime risk of developing cancer in the remaining testicle, which is significantly higher than the general population risk of less than 0.5 percent. This is why long-term surveillance of the remaining testicle is a standard part of follow-up care.
• Family history of testicular cancer: Testicular cancer can run in families. A man with a father who has had testicular cancer has roughly 4 to 6 times the average risk, and a man with a brother who has had it has approximately 8 to 10 times the average risk. The elevated risk with a brother is higher than with a father, which suggests that shared genetic factors, rather than just familial environment, are likely at play. The specific genes responsible for familial testicular cancer have not been fully identified, though several candidate regions of the genome have been studied.
• Age: Testicular cancer is most common in young men and is notably different from most other cancers in this respect. The peak incidence is between ages 20 and 34, making it the most common cancer in American males between the ages of 15 and 35. A second, smaller peak of incidence occurs in men over 60, mostly from the spermatocytic seminoma subtype, which behaves much less aggressively. While testicular cancer can occur at any age, the relatively young age of peak incidence is one of the reasons awareness among young men is so important.
• Race and ethnicity: White men have significantly higher rates of testicular cancer than men of other racial and ethnic backgrounds. The incidence in white men in the United States is approximately 5 times higher than in Black men and roughly 2 to 3 times higher than in Hispanic men. The reasons for these racial disparities are not well understood. Interestingly, the disparity in incidence does not translate into a disparity in survival, which is excellent across all groups when the cancer is diagnosed and treated promptly.
• Klinefelter syndrome: Klinefelter syndrome is a chromosomal condition in which men are born with an extra X chromosome (XXY). Men with Klinefelter syndrome have a modestly elevated risk of developing certain germ cell tumors, particularly extragonadal germ cell tumors that arise in the mediastinum (the space in the center of the chest), rather than in the testicles themselves.
• HIV infection: Men living with HIV, particularly those with AIDS, have an elevated risk of developing seminoma, the most common type of testicular germ cell tumor. The connection between immune suppression and testicular cancer risk is an active area of research.
• Body size and hormonal factors: Some research has suggested that taller men may have a modestly higher risk of testicular cancer, possibly because of hormonal factors during fetal development or puberty that influence both height and testicular germ cell behavior. The evidence for this is not conclusive, and height is obviously not something that can be modified.
• Possible prenatal exposures: Research is ongoing into whether certain exposures during fetal development, including exposure to high levels of estrogen in the womb, may increase testicular cancer risk. This is thought to be one possible explanation for the observation that men born to mothers who took diethylstilbestrol (DES) during pregnancy may have a higher risk. Most of the specific prenatal exposures that have been studied remain areas of active research rather than established risk factors.

Factors That May Lower Your Risk of Testicular Cancer

Testicular cancer does not have the same modifiable risk factor profile as cancers like lung cancer or skin cancer, where lifestyle changes can dramatically reduce risk. There is no equivalent of quitting smoking or wearing sunscreen for testicular cancer.

That said, a few approaches may be relevant.

Early orchiopexy for an undescended testicle: The most clinically relevant intervention. Surgery to move an undescended testicle into the scrotum before age 2 appears to reduce the risk of testicular cancer compared to later surgery or no surgery at all. It also makes the testicle easier to examine, allowing for earlier detection if a tumor does develop. If you or your son has or had an undescended testicle, discussing the timing and implications of treatment with a urologist or pediatric surgeon is worthwhile.

Regular testicular self-examination: Can help find it earlier, when it is most treatable. Being familiar with the normal feel of your own testicles makes it easier to notice any new lump, change in firmness, or increase in size. Many doctors and health organizations recommend that young men examine their testicles monthly. The best time is after a warm shower or bath, when the scrotal skin is relaxed. Roll each testicle gently between the thumb and fingers, feeling for any hard lump, and note the epididymis at the back of each testicle so it is not mistaken for a suspicious finding.

Staying aware of symptoms and seeking prompt medical evaluation for any new scrotal change is the most effective way to catch testicular cancer early, at the stage when treatment is most likely to be straightforward, and cure is almost certain.

Sources

1. American Cancer Society. Testicular Cancer Risk Factors. https://www.cancer.org/cancer/types/testicular-cancer/causes-risks-prevention/risk-factors.html
2. National Cancer Institute. Testicular Cancer Treatment (PDQ) Patient Version. https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq
3. Dieckmann KP, Pichlmeier U. Clinical Epidemiology of Testicular Germ Cell Tumors. World Journal of Urology. 2004;22(1):2-14. https://pubmed.ncbi.nlm.nih.gov/15034740/
4. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2024. CA: A Cancer Journal for Clinicians. 2024;74(1):12-49. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21820