Varicocele in adolescence and testicular cancer in young adulthood.

Elevated intrascrotal temperature has been suggested as a risk factor for testicular cancer, which is the most common neoplasm among young men. Varicocele was linked to increased intrascrotal temperature, but whether it is associated with testicular cancer is unclear.

To explore the possible association between varicocele at adolescence and the incidence of testicular cancer at adulthood.

This nationwide, population-based, historical cohort study includes 1,521,661 Israeli male adolecents (mean age 17.5 ± 0.4 years), who were screened for varicocele during the years 1967-2012, as part of their medical assessment prior to compulsory military service. The mean follow-up was 18± 4.2 years.

The diagnosis of testicular cancer was ascertained from linkage of records to the the Israeli National Cancer Registry. Survival analysis was applied.

In total, 53,210 adolescents were diagnosed with varicocele stage 2 and 3 prior to military service. Of 1,988 (0.13% of the total cohort) men who were diagnosed with testicular cancer during follow up, 54 (0.1%) had varicocele prior to military service while 1934(99.9%) did not, p = 0.213. The age at cancer diagnosis and the distribution of seminomas vs. non-seminomas did not differ significantly between those with and without varicocele in adolescence. In a multivariable analysis controlling for sociodemographic factors, varicocele was not associated with testicular cancer, odds ratio = 0.816 (CI 0.615-1.083).

Varicocele in adolecents was not found to be associated with testicular cancer in young adults.

In light of the theoretical association between varicocele and testicular cancer, we conducted this large population study. We found no association between varicocele in young adoulthoot and testicular cancer later in life. This article is protected by copyright. All rights reserved.

Andrology. 2022 Sep 06 [Epub ahead of print]

Guy Verhovsky, Moshe Giladi, Dorit Tzur, Arnon Afek, Lital Keinan-Boker, Estela Derazne, Dan Kaminsky, Azik Hoffman, Tomer Erlich, Tzahi Neuman

Department of Urology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel., Israel Defense Forces Medical Corps, Ramat Gan, Israel., Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 699780, Israel., Central Management, Chaim Sheba Medical Center, Tel Hashomer, Israel., Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel., Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Department of Urology, Rambam Medical Center, Heifa, Israel., Department of Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel.