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Surgery for Undescended Testes and Risk for Testicular Cancer: Age Matters

Orchiopexy in the first few years of life means less risk for testicular cancer.

At 1 year of age, about 1% of boys have undescended testes (cryptorchidism). Most experts recommend that orchiopexy should be performed before the age of 2 years because some research has suggested a link between testicular cancer and older age at surgery.

Swedish investigators identified 16,983 men in a national registry who had received a diagnosis of cryptorchidism from 1964 through 1999 and who had undergone orchiopexy before age 20 (mean age at surgery, 8.6 years). During a mean follow-up of 12.4 years, 56 men developed testicular cancer. Compared with risk in the general population, the risk for testicular cancer among those who underwent surgery before age 13 was increased (relative risk, 2.2); this twofold increased risk was noted for patients treated at all ages before 13. Among those who underwent surgery after age 13, the risk increased significantly (RR, 5.4).

Comment: These data clearly support the current recommendation that orchiopexy for undescended testes should be performed during the first few years of life.

— Howard Bauchner, MD

Published in Journal Watch General Medicine May 2, 2007

Citation(s):

Pettersson A et al. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 2007 May 3; 356:1835-41.

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