Males with a condition known as cryptorchidism, when their testes have not descended at birth, are three times more likely to develop testicular cancer later on in life as adults, according to a recent analysis published in the Archives of Disease in Childhood.
The conclusions urge the researchers to question whether boys with this condition should be routinely watched to lessen the possible risk.
Cryptorchidism is the most common birth defect in males, when the testes do not drop into the scrotum and remain in the abdomen. It affects about 6 percent of newborn boys.
Risk factors for cryptorchidism can include the following:
- Tobacco use by mother during pregnancy
- Down syndrome or other conditions that interfere with growth
- Family history of cryptorchidism
- Premature birth
- Low birth weight
- Type 1, 2 or gestational diabetes in mothers
The investigators explored the Embase and Medline databases for studies that focused on connections between cryptorchidism as an independent abnormality and testicular cancer risk, and those which have been published between the dates of January 1980 and December 2010.
They used 735 applicable papers, published in English, 12 of which matched the criteria and included corrective surgery (orchidopexy).
The chosen studies included nine case-control studies, consisting of 2281 cases of testicular cancer, which had been diagnosed between the ages of 15 and 75 between 1965 and 2006, with 4,811 controls.
It also included three cohort studies tracking identical groups of people over a long period of time to see what the outcomes would be.
The studies included over 2 million boys whose health was watched for a cumulative period of 58 million person years. Three hundred and forty-five males with cryptorchidism later got testicular cancer.
Those in the cohort studies were nearly four times more likely to develop the disease if they experienced cryptorchidism. Boys who had this condition in the case-control group were nearly 2.5 times more likely to get testicular cancer than those without it.
The investigators concluded that boys with unique cryptorchidism are three times more likely to develop testicular cancer in the future.
Testicular cancer is the most widespread cancer in men between the ages of 20 and 45, with rates rising significantly around the world over in recent years, according to the authors.
The number of new cases has increased twofold between 1975-7 and 2006-8 in the UK, rising from 3.4 per 100,000 males to 6.9 per 100,000 males.
The authors explain:
“Many important unanswered questions remain, such as how laterality, degree of descent, and surgical correction affect the malignant potential of the undescended testis. The most poignant question this study raises, however, is whether the risk of malignant transformation is sufficiently significant to warrant regular follow-up, as is the case with other premalignant states.”
Written by Kelly Fitzgerald