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Relation between the age at
treatment for undescended testis and the risk of testicular cancer
In this cohort study of 16,983 men who were surgically treated for cryptorchidism, we found that the risk of testicular cancer among men who were treated at 13 years of age or older was approximately twice that among men who underwent orchiopexy before the age of 13. The results indicate that age at treatment for cryptorchidism has an effect on the risk of testicular cancer, and thus that cryptorchidism in itself could be a cause of testicular cancer. Current clinical guidelines recommend treatment for cryptorchidism before 2 years of age, or as early as 6 months of age. Thus, our results support these guidelines. Whether treatment as early as before 1 year of age decreases the risk of future testicular cancer even further is not known, and needs to be studied further. The results also suggest that puberty, defined arbitrarily in our study as beginning at the age of 13 years, is another crucial event in testicular carcinogenesis. Testicular cancer is generally believed to be caused by environmental factors operating already in utero. Based on the results of this and other studies, we propose that future studies on the aetiology of testicular should also take postnatal exposures during puberty into account.
Bibliographic reference: Andreas Pettersson Clinical
Epidemiology Unit, Department of Medicine, Karolinska Institutet,
Stockholm, Sweden.
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