{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:53:58Z","timestamp":1785801238222,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically review and analyse the association of cannabis use with the risk of testicular germ cell tumour (TGCT), as studies have implicated an association between cannabis exposure and an increased risk of developing TGCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>The PubMed, Web of Science, and Cochrane Library databases were searched on November 2024 to identify eligible studies according to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions. Studies were selected that compared males (P: population) who had cannabis use (I: interventions) to non\u2010users or infrequent users of cannabis (C: comparators) with development of TGCT as the endpoint (O: outcomes) using multivariable analyses that adjusted for the effects of covariates (S: study type). The primary study outcome was the risk of TGCT among cannabis users. Available multivariable odds ratios (ORs) and hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were included in quantitative analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 86 articles were identified from our search, of which five were included for qualitative and quantitative analysis. Three studies were case\u2013control and two were cohort in design. Current cannabis use was significantly associated with increased risk of TGCT (OR 1.62, 95% CI 1.13\u20132.31;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05 [two studies]), as was long\u2010term (\u226510\u2009years) cannabis use (OR 1.68, 95% CI 1.19\u20132.36;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05 [three studies]). In subgroup analysis, ever cannabis use was significantly associated with increased risk of non\u2010seminomatous germ cell tumour (NSGCT) (OR 1.71, 95% CI 1.12\u20132.60;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05 [two studies]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings highlight cannabis use as a significant modifiable risk factor for the development of TGCT, particularly NSGCT. Given the increasing legalisation and availability of cannabis, further research is necessary to explore the underlying biological mechanisms and to confirm these associations across diverse populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70062","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T03:41:01Z","timestamp":1762314061000},"page":"58-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cannabis use and risk of testicular germ cell tumour: a\u00a0systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9380-8492","authenticated-orcid":false,"given":"Mehdi","family":"Kardoust Parizi","sequence":"first","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology, Shariati Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3135-8262","authenticated-orcid":false,"given":"Ichiro","family":"Tsuboi","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology Shimane University Faculty of Medicine  Izumo Shimane Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-762X","authenticated-orcid":false,"given":"Akihiro","family":"Matsukawa","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Arbuiso","sequence":"additional","affiliation":[{"name":"Department of Urology, Brady Urological Institute Johns Hopkins University  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1679-2682","authenticated-orcid":false,"given":"Joseph","family":"Cheaib","sequence":"additional","affiliation":[{"name":"Department of Urology, Brady Urological Institute Johns Hopkins University  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Medical University of Vienna  Vienna Austria"},{"name":"Karl Landsteiner Institute of Urology and Andrology  Vienna Austria"},{"name":"Urology Department, Research Center for Evidence Medicine Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Department of Urology University of Texas Southwestern Medical Center  Dallas TX USA"},{"name":"Department of Urology Weill Cornell Medical College  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmish","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology, Brady Urological Institute Johns Hopkins University  Baltimore MD USA"},{"name":"Department of Oncology Johns Hopkins University  Baltimore MD 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genetics of testicular germ cell tumors","volume":"2","author":"Sheikine Y","year":"2012","journal-title":"Am J Cancer Res"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191912759"},{"key":"e_1_2_8_16_1","article-title":"Legalization of access to cannabis: a growing agenda for tobacco control research in the USA","volume":"28","author":"Nargis N","year":"2023","journal-title":"Lancet Reg Health Am"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP11206"}],"container-title":["BJU 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