Introduction Testicular cancer is one of the most rapidly increasing tumour types but its aetiology is still largely unexplained. Cryptorchidism and familial testicular cancer, the most established risk factors, may explain <10% of all cases. Among investigated postnatal factors, early puberty was suggested as a potential risk factor but the topic has been poorly investigated.
Methods We undertook a meta-analysis of the association between age at puberty and testicular cancer risk. Search strategies were conducted in PubMed on December 2010. All markers of puberty onset (age at voice change, age at first nocturnal emission, age when started shaving, and reported age at onset) were considered. We re-categorised age at puberty from all the studies into a common three-level variable (younger age than peers, same age as peers, older age then peers), while analyses using quantitative information are ongoing.
Results A total of 348 references were retrieved, of which 11 met the inclusion criteria. Later puberty appeared to be protective. In particular later vs same age at reported onset of puberty gave an OR of 0.65 (95% CI 0.52 to 0.78) based on three studies, later vs same age at voice change an OR of 0.79 (95% CI 0.68 to 0.92) based on five studies, and later vs same age at start shaving an OR of 0.84 (95% CI 0.75 to 0.95) based on five studies. Early puberty showed a smaller or no protective effect.
Conclusion This meta-analysis has found evidence for a protective effect of later puberty for testicular cancer risk.
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