According to an article recently published in the New England Journal of Medicine, surgery before the age of 13 for the treatment of undescended testis reduces the risk of testicular cancer compared with surgery later in life.
Males born with undescended testis, also referred to as cryptorchidism, have an increased risk of developing testicular cancer compared with the general male population. Approximately 2–5% of male infants that are born full-term have cryptorchidism. The surgical procedure of moving the testis into the scrotum, or orchiopexy, may be performed as early at six months of age. It has not been determined, however, whether the age at which orchiopexy is performed affects the risk of developing testicular cancer among males with cryptorchidism.
To help clarify questions concerning age at orchiopexy and associated risks of testicular cancer, researchers from Sweden recently conducted a clinical study including nearly 17,000 men and boys from Sweden who had been diagnosed with cryptorchidism between 1965 and 2000. Data was collected from the cancer registry of Sweden and nationwide hospital discharge records. Mean follow-up was 12.4 years.
- 56 patients in this study developed testicular cancer during this time. The number of testicular cancer for the same number of men (17,000) in the general population would have only been 20.
- Among those who underwent orchiopexy before the age of 13, the risk of developing testicular cancer was slightly more than twofold that of the general male population.
- Among those who underwent orchiopexy after the age of 13, the risk of developing testicular cancer was more than fivefold that of the general male population.
The researchers concluded, “Treatment for undescended testis before puberty decreases the risk of testicular cancer.” It is recommended that parents of boys diagnosed with crytorchidism speak with their physician about their child’s individual risks and benefits of early surgery.
Reference: Pettersson A, Richiardi L, Nordenskjold A, et al. Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine. 2007; 356:1835-1841.