Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: The aetiology of testicular cancer remains elusive. In this manuscript, we review the evidence regarding the association between cannabis use and testicular cancer development. METHODS: In this systematic review and meta-analysis, we reviewed literature published between 1(st) January 1980 and 13(th) May 2015 and found three case-control studies that investigated the association between cannabis use and development of testicular germ cell tumours (TGCTs). RESULTS/CONCLUSIONS: Using meta-analysis techniques, we observed that a) current, b) chronic, and c) frequent cannabis use is associated with the development of TGCT, when compared to never-use of the drug. The strongest association was found for non-seminoma development--for example, those using cannabis on at least a weekly basis had two and a half times greater odds of developing a non-seminoma TGCT compared those who never used cannabis (OR: 2.59, 95% CI 1.60-4.19). We found inconclusive evidence regarding the relationship between cannabis use and the development of seminoma tumours. It must be noted that these observations were derived from three studies all conducted in the United States; and the majority of data collection occurred during the 1990's.
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The evidence is inconclusive for testicular seminomas, and lung cancer, neck and head cancers because of the possible roles of tobacco use, and other confounders.
“The evidence is inconclusive for testicular seminomas, and lung cancer, neck and head cancers because of the possible roles of tobacco use, and other confounders.”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [67]
The Results (Meta-analysis results; page not provided) say there was insufficient evidence to conclude that cannabis use was associated with seminoma development. The paper does not assess lung or head and neck cancers, or attribute inconclusive evidence for those cancers to tobacco use or other confounders. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe strongest association was found for non-seminoma development and weekly cannabis use.
“The strongest association was found for non-seminoma development and weekly cannabis use.”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [67]
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Cannabis Use and Risk of Psychiatric Disorders
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Teixeira, T. A., Iori, I., Andrade, G., Saldiva, P., Drevet, J., Costa, E., & Hallak, J. (2022) · Frontiers in Reproductive Health · doi:10.3389/frph.2022.820451 · Cited by 15 · see citing works
“Marijuana smoking was defined as drug use at least once a week for a minimum of 12 months (18).”
BackgroundMarijuana, lower urinary tract symptoms, and pain in the urologic patient.
Pham, M. N., Hudnall, M., & Nadler, R. (2020) · Urology · doi:10.1016/j.urology.2020.01.029 · Cited by 15 · see citing works
Trends in cancer incidence in Uruguay: 2002 -2015.
Garau, M., Musetti, C., Alonso, R., & Barrios, E. (2019) · Colombia Médica · doi:10.25100/cm.v50i4.4212 · Cited by 15 · see citing works
Dochez-Arnault, J., Desdoits-Lethimonier, C., Matias, I., Evrard, B., Lagarrigue, M., Toupin, M., Lardenois, A., Chalmel, F., Mazaud-Guittot, S., Dejucq-Rainsford, N., et al. (2023) · BMC Medicine · doi:10.1186/s12916-023-02916-5 · Cited by 14 · see citing works
Moshfeghinia, R., Najibi, A., Moradi, M., Assadian, K., & Ahmadi, J. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1438002 · Cited by 13 · see citing works
Huang, J.-Y., Huang, D., Ruan, X., Huang, J., Xu, D., Heavey, S., Olivier, J., & Na, R. (2022) · Cancer Medicine · doi:10.1002/cam4.5132 · Cited by 13
Physical activity and risk of testicular cancer: a systematic review
Huang, S., Signal, V., Sarfati, D., Shaw, C., Stanley, J., McGlynn, K., & Gurney, J. (2018) · BMC Cancer · doi:10.1186/s12885-018-4093-3 · Cited by 13 · see citing works
Self-citationTörzsök, P., Deininger, S., Abenhardt, M., Oswald, D., Lusuardi, L., Deininger, C., Forstner, R., Meissnitzer, M., Brandtner, H., & Hecht, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154390 · Cited by 12
“For risk factors such as cannabis consumption and smoking, the data are unclear [9].”
BackgroundReece, A., & Hulse, G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912759 · Cited by 12 · see citing works
Reece, A. S., & Hulse, G. K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811208 · Cited by 16 · see citing works
Cannabis packaging: An opportunity for facilitating informed decisions
Al-Hamdani, M., Joyce, K., Park, T., Cowie, M. E., & Stewart, S. (2020) · Journal of Consumer Affairs · doi:10.1111/joca.12325 · Cited by 11 · see citing works
Hasan, K. M. (2023) · Substance Abuse: Research and Treatment · doi:10.1177/11782218231182553 · Cited by 10 · see citing works
Reece, A., Bennett, K., & Hulse, G. (2023) · Journal of Xenobiotics · doi:10.3390/jox13030024 · Cited by 9 · see citing works
“19) after cannabis exposure [10], and dose response effects have been described for frequency of use [5,7], total dose exposure [4], long-term use [7] and age of first onset [5].”
BackgroundTesticular germ cell tumour risk by occupation and industry: a French case–control study – TESTIS
Guth, M., Coste, A., Lefèvre, M., Deygas, F., Danjou, A. M. N., Ahmadi, S., Dananché, B., Pérol, O., Boyle, H., Schüz, J., et al. (2023) · Occupational and Environmental Medicine · doi:10.1136/oemed-2022-108601 · Cited by 9
“Further covariates included family history of testicular cancer; family history of cryptorchidism; personal tobacco smoking; cannabis use; 24 and personal consumption of alcoholic beverages.”
Epidemiology of Δ8THC-Related Carcinogenesis in USA: A Panel Regression and Causal Inferential Study
Reece, A., & Hulse, G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19137726 · Cited by 9 · see citing works
"Considerations for the Use of Medical Cannabis: An Overview of Benefits and Harms"
Shakya, D. R. (2021) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2021.36.005886 · Cited by 8 · see citing works
Clark, T. (2020) · Cannabis and Cannabinoid Research · doi:10.1089/can.2019.0095 · Cited by 8 · see citing works
Cannabinoids and Their Role in Chronic Pain Treatment: Current Concepts and a Comprehensive Review.
Shehata, I., Hashim, A., Elsaeidy, A., Nair, A. M., Urits, I., Viswanath, O., Kaye, A., & Habib, M. (2022) · Health Psychology Research · doi:10.52965/001c.35848 · Cited by 7 · see citing works
Abdominal Imaging Manifestations of Recreational Drug Use.
Mansour, J., Zulfiqar, M., Umer, A., Zurcher, K., Heeger, A. P., & Menias, C. (2020) · Radiographics · doi:10.1148/rg.2020200048 · Cited by 7
Explaining Contemporary Patterns of Cannabis Teratology
Reece, A., & Hulse, G. (2019) · UWA Profiles and Research Repository (University of Western Australia) · doi:10.4172/2572-0775.1000146 · Cited by 7 · see citing works
“Cannabis use in adults has also been shown to be linked with significantly elevated rates of stroke, cardiac arrest, testicular cancer, chronic lung disease and hepatic fibrosis and cirrhosis [20-24].”
BackgroundThe puzzling incidence of testicular cancer in New Zealand: what can we learn?
Gurney, J. (2019) · Andrology · doi:10.1111/andr.12584 · Cited by 7
“There was therefore no discernible difference between ethnic groups in terms of the types of tumours that were occurring at a population level, suggesting that this is not a primary driver of our observed disparity in TGCT incidence (Gurney et al., 2015a,b).”
BackgroundResultInfluentialSelf-citationGenotoxicity of Marijuana in Mono-Users
Fabian-Morales, E., Fernández-Cáceres, C., Gudiño, A., Elguera, M. A. A., Torres-Arciga, K., Arrazola, M. A. E., García, L. T., Mora, Y. E. A., Oliva-Rico, D., Gutiérrez, R. E. C., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.753562 · Cited by 6 · see citing works
“Pattern of Marijuana Use Regarding characterization of pattern for marijuana use, we considered the following categories: (1) experimental, marijuana use on 1 or 2 occasions, without recurrences; (2) social, consumption begins to be more regular and framed in leisure contexts, withmore people; drug use is not an escap…”
BackgroundMethodTop Ten Tips Palliative Care Clinicians Should Know About Medical Cannabis
Briscoe, J., Kamal, A. H., & Casarett, D. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0641 · Cited by 6 · see citing works
“There is, however, a link between chronic and frequent use of cannabis and the development of testicular cancer, particularly nonseminomas.(39) Although there is no convincing evidence that cannabis use leads to chronic obstructive pulmonary disease, there is a link between smoking cannabis and cough and bronchitis, w…”
Community variation in adolescent cannabis use in Australia and the Netherlands.
Rowland, B., Jonkman, H., Williams, J., Kremer, P., & Toumbourou, J. (2019) · Addictive Behaviours · doi:10.1016/j.addbeh.2018.10.027 · Cited by 5
Johnson, R. H., Speckhart, A., Chien, F., & Bleyer, A. (2025) · Academia Oncology · doi:10.20935/acadonco7758 · Cited by 4
THE OUTCOMES OF ONCO-TESE AT THE TIME OF RADICAL ORCHIECTOMY
Flores, J., Henriquez, I., Jue, J. S., Benfante, N., Sheinfeld, J., Matulewicz, R., & Mulhall, J. (2024) · Urology · doi:10.1016/j.urology.2024.12.005 · Cited by 4
Key insights into cannabis‐cancer pathobiology and genotoxicity
Reece, A., & Hulse, G. (2024) · Addiction Biology · doi:10.1111/adb.70003 · Cited by 4
“15 The literature on cannabis and testicular cancer is almost uniformly positive and has a relative risk of around 2.6-fold, 16 this risk factor is now widely acknowledged 17 – 19 and the effect is quite fast since the median age of exposure may be about 20 years and the median age of testis cancer…”
InfluentialThe perceptions and beliefs of cannabis use among Canadian genitourinary cancer patients.
Taneja, S., Guo, Y., Slaven, M., Lalani, A., Shaw, E., Tajzler, C., Hotte, S., & Kapoor, A. (2021) · Canadian Urological Association journal = Journal de l'Association des urologues du Canada · doi:10.5489/cuaj.7197 · Cited by 4
Dairy consumption and risk of testicular cancer: a systematic review
Signal, V., Huang, S., Sarfati, D., Stanley, J., McGlynn, K., & Gurney, J. (2018) · Nutrition and Cancer · doi:10.1080/01635581.2018.1470655 · Cited by 4 · see citing works
Self-citationTesticular cancer mortality in Latin America and the Caribbean: trend analysis from 1997 to 2019
Crispin-Rios, Y., Faura-Gonzales, M., Torres-Román, J. S., Quispe-Vicuña, C., Franco-Jimenez, U. S., Valcárcel, B., Stang, A., & McGlynn, K. (2023) · BMC Cancer · doi:10.1186/s12885-023-11511-z · Cited by 3
Guth, M., Lefèvre, M., Pilorget, C., Coste, A., Ahmadi, S., Danjou, A. M. N., Dananché, B., Praud, D., Koscinski, I., Papaxanthos, A., et al. (2023) · Scandinavian Journal of Work, Environment and Health · doi:10.5271/sjweh.4102 · Cited by 3
“…birth weight, gestational age, birth order, sibship size and born from multiple pregnancy, family history of testicular cancer, family history of cryptorchidism, personal tobacco smoking ( 32 ), personal consumption of alcoholic beverages ( 33 ) and personal history of testicular trauma ( 30 ).”
BackgroundZucchi, A., Innocenzi, E., Onorato, A., Dolci, S., Colopi, A., Balistreri, C., & Grimaldi, P. (2023) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2023.111840 · Cited by 3 · see citing works
Adams, M., & Effertz, T. (2022) · Sucht : Zeitschrift für Wissenschaft und Praxis · doi:10.1024/0939-5911/a000791 · Cited by 3 · see citing works
Review of Medicinal Use of Cannabis Derivatives and the Societal Impact of Legalization
Malik, A., Fatehi, K., Menon, N., & Chaturvedi, P. (2020) · Indian Journal of Palliative Care · doi:10.4103/ijpc.ijpc_19_20 · Cited by 3 · see citing works
“[52] Studies have also noted an increased risk of developing other cancers such as nonseminoma testicular germ cell cancer, prostate cancer, and cervical cancer.[53,54]”
BackgroundSánchez-Pájaro, A., Pérez-Ferrer, C., Barrera-Núñez, D. A., Cerdá, M., Thrasher, J. F., & Barrientos-Gutiérrez, T. (2025) · The International journal on drug policy · doi:10.1016/j.drugpo.2025.104704 · Cited by 2
Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns
Samuel, S. B., Michael, M., & Tadros, M. (2023) · World Journal of Clinical Cases · doi:10.12998/wjcc.v11.i18.4210 · Cited by 2 · see citing works
Reece, A., & Hulse, G. (2022) · Archives of Public Health · doi:10.1186/s13690-022-00986-0 · Cited by 2
Mutational signatures among young-onset testicular cancers
Mealey, N. E., O'Sullivan, D., Peters, C., Heng, D., & Brenner, D. (2021) · BMC Medical Genomics · doi:10.1186/s12920-021-01121-8 · Cited by 2
Taneja, S., Hoogenes, J., Slaven, M., & Kapoor, A. (2021) · Canadian Urological Association journal = Journal de l'Association des urologues du Canada · doi:10.5489/cuaj.7198 · Cited by 2 · see citing works
An overview of the adverse effects of cannabis use for Canadian physicians.
Leduc‐Pessah, H., Jensen, S. K., & Newell, C. (2019) · Clinical and investigative medicine. Medecine clinique et experimentale · doi:10.25011/cim.v42i3.33089 · Cited by 2 · see citing works
“examined the role of cannabis use and development of testicular germ cell tumors (TGCT)[58].”
BackgroundInfluentialMedical Consequences of Cannabis Use
Khalsa, J., & Baler, R. (2018) · Cannabis Use Disorders · doi:10.1007/978-3-319-90365-1_15 · Cited by 2 · see citing works
Mohammadpour-Asl, S., Roshan-Milani, S., Fard, A. A., & Golchin, A. (2023) · BMC Pharmacology and Toxicology · doi:10.1186/s40360-023-00704-8 · Cited by 1 · see citing works
“…that regular marijuana use has been linked to a lower semen quality and testosterone level [2–5] as well as a higher risk of testicular cancer [6, 7]. δ-9-tetrahydrocannabinol (THC), the major constituent and the primary active component of the marijuana, is a receptor agonist for the…”
BackgroundImpact of Tobacco and Marijuana on Infertility and Early Reproductive Wastage
Bortoletto, P., & Prabhu, M. (2022) · Clinical obstetrics and gynecology · doi:10.1097/grf.0000000000000689 · Cited by 1
Assessment of Complete Blood Counts of Cannabis sativa Smokers in Ekpoma, Edo State, Nigeria
Amaechi, R., Babatope, I., Abulele, P. O., & Obodo, B. (2020) · doi:10.9734/acri/2020/v20i730212 · Cited by 1
Pathologies urologiques liées à une consommation de cannabis
Lannes, F., Gondran-tellier, B., Lechevallier, É., & Baboudjian, M. (2020) · doi:10.1016/j.fpurol.2020.04.004 · Cited by 1
“Une méta-analyse de 2015 rapportait en effet une augmentation du risque de TGT chez les patients ayant une consommation prolongée de cannabis [4].”
BackgroundMedicinal cannabis: presenting possible treatment modalities for the future.
Khalil, H. (2018) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000145 · Cited by 1
“It is estimated that 178 million people aged 15–64 years used cannabis at least once in 2012.(1) Cannabis or cannabinoids used to manage medical conditions is referred to as medicinal cannabis.”
BackgroundJimenez, R., Gupta, S., Hernandez, L. P. H., & Sebo, T. (2017) · doi:10.1007/978-3-662-53775-6_7 · Cited by 1
Mehareen, J., Altman, R. M., de Vera, M., Goddard, K. J., Howard, F., Hu, X. J., Lai, A., Lo, A. C., McTaggart-Cowan, H., Oh, J., et al. (2026) · Journal of Adolescent and Young Adult Oncology · doi:10.1177/21565333261470581
Projecting Individualized Probabilities of Lifetime Total Cancer Risk Across a Population
Butala, N. M., Al-Hammadi, N., Ediriwickrema, A., Schneider, J. L., Fullerton, A. M., Balasubramanian, J., Choudhury, P. P., & Chatterjee, N. (2026) · JCO Oncology Advances · doi:10.1200/oa-25-00209
[Prevention and treatment of male cancers: a comprehensive approach].
Larose, C., Chauveau, É., & Samhani, C. (2025) · Soins · doi:10.1016/j.soin.2025.09.006
Urogenital Malignancy and Cannabis Use: A Narrative Review
Thomson, A., McVey, A., Timm, B., & Bolton, D. M. (2023) · Société Internationale d'Urologie Journal · doi:10.48083/ndoj8638
“Duration of cannabis use ( > 10 years versus never used) increased likelihood of TGCT development (OR 1.5; 95% CI 1.08 to 2.09)[44].”
Influential
- Authors
- Gurney, J., Shaw, C., Stanley, J., Signal, V., & Sarfati, D.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Gurney, J.
- Venue
- BMC Cancer
- Published
- 2015-11-11
- Volume
- 15
- Issue
- 1
- Pages
- 897-897
- ISSN
- 1471-2407 (ISSN-L)
- PMC
- PMC4642772
- OpenAlex
- W2118479499
- Cited by
- 137
- References
- 35
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 9 · 2023: 25 · 2022: 16 · 2021: 15 · 2020: 19 · 2019: 18 · 2018: 14 · 2017: 7 · 2016: 2
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Cancer (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Health Research Council of New Zealand (NZ) (14/052)
- Topics
- Health Sciences › Medicine › Surgery › Testicular diseases and treatments
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cannabis use, testicular cancer, testicular germ cell tumors, non-seminoma, seminoma, cancer risk factors, chronic cannabis use, case-control study
- MeSH terms
- Cannabis, Humans, Male, Neoplasms, Germ Cell and Embryonal, Risk Factors, Testicular Neoplasms, United States, Case-Control Studies
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