Background
Methods
Search strategy
Protocol and registration
Eligibility criteria
Information sources
Search terms
Exposure-related keywords | Outcome-related keywords |
---|---|
Physical activit* | Cancer of the testi* |
Exercis* | Testi*cancer |
Sport* | Testi* carcinoma |
Fitness* | Testi* tumour |
Occupational activit* | Testi* neoplasm |
Recreational activit* | Testi* germ cell tumour |
Aerobic* | Seminoma |
Anaerobic | Non-seminoma |
Teratoma | |
Testi* Choriocarcinoma |
Study selection and data extraction
Screening of abstracts
Data extraction
Assessment of risk of bias (individual and across studies)
Results
Literature search results
Meta-data for included studies
Assessment of study quality
Disparate physical activity measurements
High vs. low levels of physical activity
Dose-response relationship
Types of recreational physical activity
Author | Study design | Exposure | Level of exposure/ comparator | Measure of relative risk (OR/RR/HR) | Reported crude OR/RR/HR (95% CI) | Reported adjusted OR/RR/HR (95% CI) | Number of exposed vs. nonexposed cases | Number of exposed vs. nonexposed controls/cohort | Adjustment for confounding |
---|---|---|---|---|---|---|---|---|---|
Coldman [6] | CCS | Cycling Horse-riding Motorcycling Soccer | Regular participation throughout lifetime | OR | Cycling 1.99 (1.04–3.81) | 44 exposed 84 non-exposed (34% exposed) | 28 exposed 100 non-exposed (22% exposed) | Controls matched for age and year of diagnosis but analysed in unmatched fashion Adjust cycling and horse-riding for cryptorchidism, juvenile onset inguinal hernia and for each other | |
Horse-riding 3.31 (1.36–8.25) | 25 exposed 103 non-exposed (20% exposed) | 9 exposed 119 non-exposed (7% exposed) | |||||||
Motorcycling 1.04 (0.43–2.41 | 16 exposed 112 non-exposed (13% exposed) | 15 exposed 113 non-exposed (12% exposed) | |||||||
Soccer 1.11 (0.50–2.50) | 8 exposed 110 non-exposed (14% exposed) | 16 exposed 112 non-exposed (13% exposed) | |||||||
Cycling as a teenager for recreation or for transport to school | Regular participation as a teen | In teens Cycling for recreation 1.81 (0.88–3.75) | 62 exposed 66 non-exposed (48% exposed) | 49 exposed 79 non-exposed (38% exposed) | |||||
Cycling to school 1.79 (0.91–3.55) | 40 exposed 88 non-exposed (31% exposed) | 27 exposed 101 non-exposed (21% exposed) | |||||||
Frequency of horse riding | ≥1 time/mth for ≥1 year | Frequent v.s. non-frequent 2.09 (0.88–5.08) | 21 exposed 107 non-exposed (16% exposed) | 11 exposed 117 non-exposed (9% exposed) | |||||
Forman [20] | CCS | Cycling Horse-riding Contact sports (football, rugby, hockey, lacrosse) Racquet sports Water sports Athletics Cricket, baseball and rounders Martial arts | Regular participation at ref. age, age 16 and age 20 | OR | Cycling, horse-riding, racquet sports, cricket, baseball and rounders Unrelated to TC risk |
Information not provided
|
Information not provided
| Controls matched for age Additional adjustment for cryptorchidism, juvenile onset inguinal hernia and total exercise | |
Contact sports At ref. age 0.73 (0.55–0.97) At age 20 0.80 (0.64–1.00 | |||||||||
Water sports At ref. age 0.87 (0.66–1.16) At age 16 0.74 (0.58–0.96) At age 20 0.74 (0.56–0.98 | |||||||||
Athletics At ref. age 0.70 (0.51–0.97 | |||||||||
Martial arts At ref. age 0.67 (0.29–1.54) At age 16 0.42 (0.21–0.82) At age 20 0.52 (0.29–0.94) | |||||||||
Littman [22] | CCS | Cycling Horse-riding Motor biking Mountain biking Soccer Basketball Wrestling | Regular participation during grades 7–12-yes/no | OR | Cycling 1.0 (0.7–1.3) | 250 exposed 141 non-exposed (64% exposed) | 658 exposed 365 non-exposed (64% exposed) | Controls matched for age and area of residence Additional adjustment for income, ethnicity, cryptorchidism. Each activity further adj. For all other activities | |
Horse-riding 0.8 (0.6–1.1) | 68 exposed 323 non-exposed (17% exposed) | 210 exposed 813 non-exposed (21% exposed) | |||||||
Motor biking 0.9 (0.7–1.2) | 144 exposed 247 non-exposed (37% exposed) | 409 exposed 614 non-exposed (40% exposed) | |||||||
Mountain biking 0.9 (0.6–1.3) | 51 exposed 263 non-exposed (16% exposed) | 143 exposed 734 non-exposed (16% exposed) | |||||||
Duration of participation during grades 7–12 in tertiles | Soccer 1–8 months 1.9 (1.2–3.1) Basketball 1–8 months 1.5 (1.0–2.2) Wrestling 6–11 months 0.4 (0.2–0.8) ≥12 months 0.8 (0.4–1.4) |