[Testicular cancer - a matter of geography? Epidemiology and etiopathogenesis of germ cell tumors]

Awareness of testicular cancer among adult Polish men and their tendency for prophylactic self-examination: conclusions from Movember 2020 event

BACKGROUND

Testicular cancer (TC), due to its non-specific symptoms and occurrence in young men, is particularly dangerous. A critical point for early diagnosis is awareness of the disease and the willingness to perform a testicular self-examination (TSE). The main aim of the study was to assess the knowledge of 771 adult men about testicular cancer. Additionally, the sources of information on TC and TSE were analyzed and the influence of demographic factors on the willingness to join preventative programs was examined.

MATERIALS AND METHODS

The study was carried out during the Movember2020 campaign, where a testicular ultrasound was performed on participants. They were asked to complete a questionnaire with 26 questions to assess their knowledge.

RESULTS

The results obtained in the study indicate a low level of knowledge (average 3.5 points out of 18) about TC. Living in a large city (OR = 1.467; p = 0.03), as well as an earlier conversation about TC (OR = 1.639; p = 0.002), increased the awareness about the disease. Additionally it showed that many participants do not perform TSE at all (52.4%) and that only few perform TSE frequently (18.4%). Relationship status (OR = 2.832; p < 0.001) and previous conversations about TC (OR = 1.546; p = 0.02) was reported to be the main contributing factors in males deciding to have TSE.

CONCLUSIONS

Our research indicates large educational neglect in terms of knowledge about TC and reluctance in performing TSE. It is worth carrying out preventative actions periodically on an increasing scale, not only for the screening of testicular cancer, but also to expand knowledge on this subject.

[Germ cell and sex cord-stromal tumors of the testis : WHO classification 2016]

Earlier revisions of the WHO classification of testicular tumors, which was originally published in 1977, contained only minor additions. In the WHO 2016 classification, in contrast, germ cell tumors are split into two major groups based on their distinct pathohistogenesis, i. e., those which derive from an in situ forerunner lesion and those which do not. The latter category includes prepubertal yolk sac tumors and teratomas, as well as spermatocytic seminoma. The classification of yolk sac tumors and teratomas as arising before or after puberty is also of prognostic value. The group of trophoblastic tumors has also been divided into choriocarcinoma and "nonchoriocarcinomatous trophoblastic tumors," which are rare but may also be clinically significant. The changes in the classification of the sex cord-stromal tumors are not particularly important; rare variants without clinical importance of the single well-known tumors have been omitted. A new entity, a kind of "in situ" large cell Sertoli cell neoplasia, has been introduced.

Malignant testicular tumour incidence and mortality trends

Aim of the study

In Poland testicular tumours are the most frequent cancer among men aged 20–44 years. Testicular tumour incidence since the 1980s and 1990s has been diversified geographically, with an increased risk of mortality in Wielkopolska Province, which was highlighted at the turn of the 1980s and 1990s. The aim of the study was the comparative analysis of the tendencies in incidence and death rates due to malignant testicular tumours observed among men in Poland and in Wielkopolska Province.

Material and methods

Data from the National Cancer Registry were used for calculations. The incidence/mortality rates among men due to malignant testicular cancer as well as the tendencies in incidence/death ratio observed in Poland and Wielkopolska were established based on regression equation. The analysis was deepened by adopting the multiple linear regression model. A p-value < 0.05 was arbitrarily adopted as the criterion of statistical significance, and for multiple comparisons it was modified according to the Bonferroni adjustment to a value of p < 0.0028. Calculations were performed with the use of PQStat v1.4.8 package.

Results

The incidence of malignant testicular neoplasms observed among men in Poland and in Wielkopolska Province indicated a significant rising tendency. The multiple linear regression model confirmed that the year variable is a strong incidence forecast factor only within the territory of Poland. A corresponding analysis of mortality rates among men in Poland and in Wielkopolska Province did not show any statistically significant correlations.

Conclusions

Late diagnosis of Polish patients calls for undertaking appropriate educational activities that would facilitate earlier reporting of the patients, thus increasing their chances for recovery. Introducing preventive examinations in the regions of increased risk of testicular tumour may allow earlier diagnosis.