Abstract
Clinical factors were studied in a population based survey of 1,116 cases of testicular neoplasms in Victoria, Australia, between 1950 and 1978. The ratio of right to left sided tumours was 54:46, but the left side predominated among sarcomas (P = 0.006), and in older men. The relative risk (RR) for men with unilateral maldescent was 15 (CI 10-23) and for men with bilateral maldescent 33 (CI 20-55) (odds ratio 1.4, CI 0.5-4, P = 0.7). Calculations per testis in men with unilateral maldescent showed an elevated risk for both the maldescended testis (RR 28, CI 19-41, P less than 0.0001) and the normally descended testis (RR 3, CI 1.2-6, P = 0.04). The RR for men with abdominal maldescent was 55 (CI 36-83) compared to 7 (CI 4-11) for those with inguinal maldescent (odds ratio 8, CI 3-20, P less than 0.0001). Seminomas were more common than nonseminomas (NSGCT) in men with a history of maldescent (odds ratio 1.7, CI 1.1-3, P = 0.02) and also among corrected cryptorchids compared to uncorrected (P = 0.005). Seminomas were diagnosed at an earlier median age in men with corrected cryptorchid testes compared to uncorrected (P = 0.03) and in men with corrected cryptorchid testes compared to normally descended (P = 0.001). Maldescent was also associated with hernia (P = 0.04). Twenty-eight per cent of patients recorded a history of trauma with a higher proportion among NSGCT than among seminomas (P = 0.03). Prior malignancies were reported in nine patients, compared to 3.6 expected; prostate cancer (2) and malignant melanoma (2) were the greatest contributors to the excess.
Highlights
For the purpose of investigation of clinical associations and risk factors, we selected cases diagnosed in the period 1950-1978, resident in Victoria and with a malignancy primary in the testis defined according to the rules of the International Classification of Diseases (World Health Organization, 1967)
Most deviant were sarcomas (P = 0.006 sarcomas compared to the rest of the series combined)
Evidence of the factors determining the relationship between cryptorchidism and testicular malignancy remains contradictory and confusing
Summary
For the purpose of investigation of clinical associations and risk factors, we selected cases diagnosed in the period 1950-1978, resident in Victoria and with a malignancy primary in the testis defined according to the rules of the International Classification of Diseases (World Health Organization, 1967). The date of diagnosis was defined as the date of orchidectomy, biopsy of metastasis or post-mortem. In the absence of pathological evidence, the date of diagnosis on a clinical basis was used. Unless otherwise specified bilateral tumours were treated as a single case, the first malignancy being used for analysis when they were not simultaneous
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