“This is the first time that a clear age limit – at the age of thirteen – has been defined where we can see that the risk of cancer rises sharply if the operation is not performed in time,” says associate professor Olof Akre, who has led the study.
One of the most common irregularities in new born male babies is that only one testicle descends into the scrotum, the other normally remaining in the groin. This problem can be surgically corrected, and doctors have long known that it can increase the risk of infertility and testicular cancer.
The study, which is presented in the New England Journal of Medicine, included almost 17,000 men in Sweden who had undergone surgery for an undescended testis between 1964 and 1999. The data was collected from the patient registry and then cross-referenced with the Cancer Registry. Fifty-six cases of testicular cancer were noted during the period. It was found that those who had been operated on before the age of thirteen ran approximately double the risk of developing cancer compared with the normal population. If the operation had been performed after the age of thirteen, the risk was over five and a half times as great.
“It seems to be important to correct the defect before puberty,” says Dr Akre. “We are now studying how the timing of the operation affects fertility. According to current recommendations, the operation should be carried out before the age of one.”
Testicle cancer strikes about 250 men a year in Sweden and is the most common form of cancer in young men. Over 95 per cent of those who develop the disease are cured with surgical and oncological treatment.
“Age at Surgery for Undescended Testis and Risk of Testicular Cancer”
Andreas Pettersson, Lorenzo Richiardi, Agneta Nordenskjold, Magnus Kaijser and Olof Akre
New England Journal of Medicine, 3 May 2007, s 1835-41