Study summary

Chemotherapy and radiation raised the later risk of a second cancer; surgery alone did not

Second cancers review · 88,863 men in 21 studies · Published December 2025, Journal of the National Cancer Institute

What was tested

A pooled look at studies following men treated for testicular germ cell cancer for a median of 12.5 years, comparing their rate of new, unrelated cancers with the general population.

What they found

• Men treated with surgery alone had no more second cancers than expected.
• After radiation the rate was 1.66 times expected, after chemotherapy 1.65 times, and after both 2.73 times.
• Certainty in the evidence was rated low to moderate.

What it means

Because most men are cured, long-term side effects matter. This supports choosing the least treatment that still cures, such as surveillance for stage I.