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Cayuela L, Cabrera Fernández S, Pereyra-Rodríguez JJ, Hernández-Rodríguez JC, Cayuela A. Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis. Actas Urol Esp 2024:S2173-5786(24)00063-5. [PMID: 38734070 DOI: 10.1016/j.acuroe.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model. METHODS We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends. RESULTS A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s. CONCLUSION While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.
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Affiliation(s)
- L Cayuela
- Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Spain
| | - S Cabrera Fernández
- 061 Centro de Emergencias Sanitarias, Servicio Andaluz de Salud, Sevilla, Andalucía, Spain
| | - J J Pereyra-Rodríguez
- Facultad de Medicina, Universidad de Sevilla, Spain; Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - A Cayuela
- Unidad de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.
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2
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Lai DKH, Cheng ESW, Mao YJ, Zheng Y, Yao KY, Ni M, Zhang YQ, Wong DWC, Cheung JCW. Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. Cancers (Basel) 2023; 15:3770. [PMID: 37568585 PMCID: PMC10417060 DOI: 10.3390/cancers15153770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The objective of this review was to summarize the applications of sonoelastography in testicular tumor identification and inquire about their test performances. Two authors independently searched English journal articles and full conference papers from CINAHL, Embase, IEEE Xplore®, PubMed, Scopus, and Web of Science from inception and organized them into a PIRO (patient, index test, reference test, outcome) framework. Eleven studies (n = 11) were eligible for data synthesis, nine of which (n = 9) utilized strain elastography and two (n = 2) employed shear-wave elastography. Meta-analyses were performed on the distinction between neoplasm (tumor) and non-neoplasm (non-tumor) from four study arms and between malignancy and benignity from seven study arms. The pooled sensitivity of classifying malignancy and benignity was 86.0% (95%CI, 79.7% to 90.6%). There was substantial heterogeneity in the classification of neoplasm and non-neoplasm and in the specificity of classifying malignancy and benignity, which could not be addressed by the subgroup analysis of sonoelastography techniques. Heterogeneity might be associated with the high risk of bias and applicability concern, including a wide spectrum of testicular pathologies and verification bias in the reference tests. Key technical obstacles in the index test were manual compression in strain elastography, qualitative observation of non-standardized color codes, and locating the Regions of Interest (ROI), in addition to decisions in feature extractions. Future research may focus on multiparametric sonoelastography using deep learning models and ensemble learning. A decision model on the benefits-risks of surgical exploration (reference test) could also be developed to direct the test-and-treat strategy for testicular tumors.
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Affiliation(s)
- Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ethan Shiu-Wang Cheng
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yi Zheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ke-Yu Yao
- Department of Materials, Imperial College, London SW7 2AZ, UK
| | - Ming Ni
- Department of Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
- Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Ying-Qi Zhang
- Department of Orthopaedics, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
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3
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Jansson AK, Söderling J, Reutfors J, Thor A, Sköld C, Cohn-Cedermark G, Ståhl O, Smedby KE, Pettersson A, Glimelius I. Risk and mortality of testicular cancer in patients with neurodevelopmental or other psychiatric disorders. Br J Cancer 2023; 128:2261-2269. [PMID: 37088800 PMCID: PMC10241835 DOI: 10.1038/s41416-023-02260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Both testicular germ cell tumours (TGCT) and neurodevelopmental disorders are associated with urogenital malformations. Few studies have investigated the association between psychiatric disorders and TGCT. We investigated whether history of any psychiatric or neurodevelopmental disorder is associated with increased risk or mortality of TGCT. METHOD This is a nested case-control study including 6166 TGCT patients diagnosed during 1992-2014, individually matched for age and calendar period to 61,660 controls. We calculated odds ratios (ORs) for the association between type of psychiatric diagnoses and TGCT risk. Among the cases, we used a cohort design and calculated hazard ratios (HRs) of the association between psychiatric diagnose and all-cause and TGCT-specific death. RESULTS History of a neurodevelopmental disorder (attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disabilities) was associated with an increased risk of seminoma (OR: 1.54; 1.09-2.19). Seminoma patients with neurodevelopmental disorders were younger (34 versus 38 years, p = 0.004) and had more stage IV disease (5.4% versus 1.2%) than those without. Psychiatric history overall was not associated with TGCT. Patient history of any psychiatric disorder was associated with an increased all-cause and TGCT-specific death. CONCLUSIONS We report an association between neurodevelopmental disorders and testicular seminoma, and an increased TGCT-specific mortality for TGCT patients with psychiatric disorders.
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Affiliation(s)
- Anna K Jansson
- Department of Immunology, Genetics & Pathology, Uppsala University, Uppsala, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Johan Reutfors
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anna Thor
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Sköld
- Department of Immunology, Genetics & Pathology, Uppsala University, Uppsala, Sweden
| | - Gabriella Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Genitourinary Oncology Unit, Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Olof Ståhl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Pettersson
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Glimelius
- Department of Immunology, Genetics & Pathology, Uppsala University, Uppsala, Sweden.
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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4
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Brönimann S, Mun DH, Hackl M, Yang L, Shariat SF, Waldhoer T. Increase and Plateauing of Testicular Cancer Incidence in Austria-A Time Trend Analysis of the Past Four Decades. EUR UROL SUPPL 2023; 49:104-109. [PMID: 36874603 PMCID: PMC9974997 DOI: 10.1016/j.euros.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Background Testicular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have been increasing in many countries since, at least, the mid-20th century. Objective To investigate the incidence rates of TGCTs in Austria by analyzing data from the Austrian Cancer Registry. Design setting and participants Available data between 1983 and 2018 were provided by the Austrian National Cancer Registry and analyzed retrospectively. Outcome measurements and statistical analysis Germ cell tumors derived from germ cell neoplasia in situ were classified into seminomas and nonseminomas. Age-specific incidence rates and age-standardized rates were calculated. Annual percent changes (APCs) and average annual percent changes in incidence rates were determined to describe trends from 1983 to 2018. All statistical analyses were performed using SAS version 9.4 and joinpoint. Results and limitations The study population consists of 11 705 patients diagnosed with TGCTs. The median age at diagnosis was 37.7 yr. The standardized incidence rate of TGCTs increased significantly (p < 0.0001) from 4.1 (3.4, 4.8) per 100 000 in 1983 to 8.7 (7.9, 9.6) per 100 000 in 2018 by an average APC of 1.74 (1.20, 2.29). The joinpoint regression revealed a change point in time trend in 1995 with an APC of 4.24 (2.77, 5.72) before 1995 and an APC of 0.47 (0.06, 0.89) thereafter. Incidence rates were about twice as high for seminomas as for nonseminomas. A trend analysis by age group showed that the highest TGCT incidence rate was observed among men aged 30-40 yr, with a steep increase before 1995. Conclusions The incidence rate of TGCTs increased in Austria over the past decades and appears to have reached a plateau at a high level. A time trend analysis by age group for the overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. These data should lead to awareness campaigns and research to further investigate the causes of this development. Patient summary We reviewed the data between 1983 and 2018 provided by the Austrian National Cancer Registry to analyze the incidence and incidence trend in testicular cancer. Testicular cancer shows an increasing incidence in Austria. The overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. The incidence appears to have reached a plateau at a high level in recent years.
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Affiliation(s)
- Stephan Brönimann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Dong-Ho Mun
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Preventive Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.,Karl Landsteiner Institute, Vienna, Austria
| | - Thomas Waldhoer
- Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
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5
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Danjou AMN, Pérol O, Coste A, Faure E, Béranger R, Boyle H, Belladame E, Grassot L, Dubuis M, Spinosi J, Bouaoun L, Fléchon A, Bujan L, Drouineaud V, Eustache F, Berthaut I, Perrin J, Brugnon F, Charbotel B, Schüz J, Fervers B. Domestic use of pesticides during early periods of development and risk of testicular germ cell tumors in adulthood: a French nationwide case-control study. Environ Health 2021; 20:111. [PMID: 34706722 PMCID: PMC8554827 DOI: 10.1186/s12940-021-00795-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 10/07/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Testicular germ cell tumours (TGCT) are the most frequent cancers in young men in developed countries and their incidence rate has doubled worldwide over the past 40 years. Early life exposures to pesticides are suspected to increase TGCT risk. Our research aimed at estimating adult TGCT risk associated with parental domestic use of pesticides during early periods of child development. METHODS We conducted a case-control study of 304 TGCT cases, aged 18-45 years old, recruited in 20 French university hospitals, and 274 controls frequency-matched on hospital and birth year. Participants' mothers provided information on their domestic use of pesticides from 1 year before start of pregnancy to 1 year after their son's birth, for gardening activities, treatment of indoor plants, pets, wood and mold, and pest control. Odds ratios (OR) for TGCT (overall and by histological subtype) and 95% confidence intervals (CI) were estimated using conditional logistic regression. RESULTS Prevalence of reported domestic use of pesticides was 77.3% for insecticides, 15.9% for fungicides and 12.1% for herbicides. While no association was found for any use of insecticides (OR = 1.27, CI = 0.80-2.01) or herbicides (OR = 1.15, CI = 0.67-2.00), elevated risks of TGCT overall (OR = 1.73, CI = 1.04-2.87) and non-seminoma subtype (OR = 2.44, CI = 1.26-4.74) were observed for any use of fungicides. When specific purposes were examined, using fungicides and/or insecticides for woodwork (OR = 2.35, CI = 1.06-5.20) and using insecticides on cats and dogs (OR = 1.95, CI = 1.12-3.40) were associated with increased risk of non-seminoma subtype. We found no association for seminoma subtype. CONCLUSIONS Although recall bias may partially explain the elevated ORs, our study provides some evidence of a positive association between domestic use of pesticides during early periods of development, particularly fungicides and risk of adult TGCT and non-seminoma. Given the common domestic use of pesticides in France, further research on TGCT risk is warranted.
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Affiliation(s)
- Aurélie M. N. Danjou
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Olivia Pérol
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Astrid Coste
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Elodie Faure
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Gustave Roussy, Équipe “Exposome et Hérédité”, CESP, 94805 Villejuif, France
| | - Rémi Béranger
- IRSET (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, INSERM, EHESP, CHU Rennes, Rennes University, Rennes, France
| | - Helen Boyle
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Elodie Belladame
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Lény Grassot
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Matthieu Dubuis
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Johan Spinosi
- Direction Santé Travail, équipe associée à L’UMRESTTE (UMR T 9405 Université Lyon 1, IFSTTAR), Santé publique France, Lyon, France
| | - Liacine Bouaoun
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Aude Fléchon
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Louis Bujan
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM 1202 Universités Montpellier et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
- Fédération Française des CECOS, Paris, France
| | - Véronique Drouineaud
- Fédération Française des CECOS, Paris, France
- CECOS Hôpital Cochin, Paris, France
| | - Florence Eustache
- Fédération Française des CECOS, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
| | - Isabelle Berthaut
- Fédération Française des CECOS, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
- APHP Sorbonne University, Paris, France
| | - Jeanne Perrin
- Fédération Française des CECOS, Paris, France
- CNRS, IRD, IMBE, Avignon University, Aix Marseille University, Marseille, France
- Centre Clinico-Biologique d’AMP-CECOS, AP-HM La Conception University Hospital, Marseille, France
| | - Florence Brugnon
- Fédération Française des CECOS, Paris, France
- CHU Clermont-Ferrand, CHU Estaing, AMP, CECOS, Clermont-Ferrand, France
- IMOST, INSERM U1240, Faculté Médecine Clermont-Ferrand, Clermont-Ferrand, France
| | - Barbara Charbotel
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- UMRESTTE, UMR T 9405, IFSTTAR, Lyon 1 University, Lyon University, Eiffel University, Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Béatrice Fervers
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - For the TESTIS study group
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Gustave Roussy, Équipe “Exposome et Hérédité”, CESP, 94805 Villejuif, France
- IRSET (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, INSERM, EHESP, CHU Rennes, Rennes University, Rennes, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- Direction Santé Travail, équipe associée à L’UMRESTTE (UMR T 9405 Université Lyon 1, IFSTTAR), Santé publique France, Lyon, France
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM 1202 Universités Montpellier et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
- Fédération Française des CECOS, Paris, France
- CECOS Hôpital Cochin, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
- APHP Sorbonne University, Paris, France
- CNRS, IRD, IMBE, Avignon University, Aix Marseille University, Marseille, France
- Centre Clinico-Biologique d’AMP-CECOS, AP-HM La Conception University Hospital, Marseille, France
- CHU Clermont-Ferrand, CHU Estaing, AMP, CECOS, Clermont-Ferrand, France
- IMOST, INSERM U1240, Faculté Médecine Clermont-Ferrand, Clermont-Ferrand, France
- UMRESTTE, UMR T 9405, IFSTTAR, Lyon 1 University, Lyon University, Eiffel University, Lyon, France
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Gurney JK, Florio AA, Znaor A, Ferlay J, Laversanne M, Sarfati D, Bray F, McGlynn KA. International Trends in the Incidence of Testicular Cancer: Lessons from 35 Years and 41 Countries. Eur Urol 2019; 76:615-623. [PMID: 31324498 PMCID: PMC8653517 DOI: 10.1016/j.eururo.2019.07.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/02/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Incidence rates of testicular cancer (TC) have been increasing in many countries since, at least, the mid-20th century without clear explanation. Examining the varying trends across countries and time provides clues to understanding the causes of TC. OBJECTIVE We have presented incidence data from 41 countries and evaluated incidence trends for the 35-yr period from 1978 to 2012. DESIGN, SETTING, AND PARTICIPANTS Cancer registry data from Cancer Incidence in Five Continents (CI5) volumes V-XI, CI5plus, and the NORDCAN database were analysed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Age-standardised rates of TC overall and by histological type were calculated. A joinpoint regression model of the natural log-transformed rates was used to calculate the average annual percent change (AAPC) in incidence. Age-period-cohort modelling was used to examine the effect of birth cohort on rates. RESULTS AND LIMITATIONS While the highest incidence of TC remains in Northern Europe, the gap is closing between higher- and lower-incidence regions. Age-period-cohort modelling found flattening of risk among recent cohorts in Denmark and the UK, a steady increase in risk in the USA (particularly for seminomas), and an increase in risk among more recent cohorts in Costa Rica, Croatia, and Slovakia. CONCLUSIONS The gap between low- and high-incidence countries is closing due to increases in the former and stabilisation in the latter. Understanding the causes of these and other differences in incidence rates between, and within, countries may help further our understanding of the aetiology of this cancer. PATIENT SUMMARY We examined the rates of testicular cancer in different countries over time. These rates have been increasing, although the rates in high-incidence countries seem to be slowing down, while rates in low-incidence countries are catching up. These trends might help us understand what is causing testicular cancer in general.
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Affiliation(s)
- Jason K Gurney
- Cancer and Chronic Conditions Research Group, Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Andrea A Florio
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ariana Znaor
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Diana Sarfati
- Cancer and Chronic Conditions Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Drevinskaite M, Patasius A, Kincius M, Jievaltas M, Smailyte G. A Population-Based Analysis of Incidence, Mortality, and Survival in Testicular Cancer Patients in Lithuania. ACTA ACUST UNITED AC 2019; 55:medicina55090552. [PMID: 31480363 PMCID: PMC6780107 DOI: 10.3390/medicina55090552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Background and objectives: The aim of this study was to analyze trends in testicular cancer incidence, mortality, and survival in Lithuania during the period 1998–2013. Materials and Methods: The study was based on all cases of testicular cancer reported to the Lithuanian Cancer Registry between 1998 and 2013. Age group-specific rates and standardized rates were calculated using the direct method (European standard population). The Joinpoint regression model was used to provide the annual percentage change (APC). Five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of cancer patients and the expected survival of the underlying general population. Results: During the study period, the age-standardized incidence rate of testicular cancer increased from 1.97 to 3.45 per 100,000, with APC of 2.97% (95% CI 0.9 to 5.1). Incidence rate of seminomas changed from 0.71 to 1.54 per 100,000, with APC of 2.61% (95% CI −0.4 to 5.7), and the incidence rate of non-seminomas increased from 0.84 to 1.83 per 100,000, with APC of 4.16% (95% CI 1.6 to 6.8). The mortality rate of testicular cancer in Lithuania during this period declined from 0.78 to 0.51 per 100,000, with APC of −2.91% (95% CI −5.5 to −0.3). Relative five-year survival ratio for the period 2009–2013 was 89.39% (95% CI 82.2 to 94.4). In our study, the overall five-year relative survival increased slightly (10.1%) from 2004–2008 to 2009–2013 (from 79.3% to 89.4%). Conclusions: A moderate increase of testicular cancer incidence has been observed in Lithuania between the years 1998 and 2013, while the mortality rate decreased. The five-year relative survival increased according to different period estimates; however, the results could have been higher if a multidisciplinary approach to diagnostics and management in the concerned centers had been implemented in Lithuania as in other countries.
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Affiliation(s)
- Mingaile Drevinskaite
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania.
| | - Ausvydas Patasius
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Marius Kincius
- Department of Oncourology, National Cancer Institute, 08406 Vilnius, Lithuania
| | - Mindaugas Jievaltas
- Urology department, Lithuanian University of Health Sciences, Medicine Academy, 44307 Kaunas, Lithuania
| | - Giedre Smailyte
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
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Gurney JK. The puzzling incidence of testicular cancer in New Zealand: what can we learn? Andrology 2019; 7:394-401. [PMID: 30663250 DOI: 10.1111/andr.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/16/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Testicular germ cell tumour is the most common cancer to be diagnosed among young men. In New Zealand, we have observed some puzzling trends in the epidemiology of this disease. METHODS We have conducted a narrative review of available evidence regarding the puzzling epidemiology of testicular germ cell tumour in New Zealand and discussed the possible drivers of these trends. RESULTS AND DISCUSSION Whereas testicular cancer is most commonly a disease of White men, in New Zealand it is the indigenous Māori population that suffer by far the greatest rate of disease (age-adjusted relative risk: 1.80, 95% CI 1.58-2.05). Even more curiously, the rate of testicular germ cell tumour among Māori men aged 15-44 (28/100,000) is substantially greater than for Pacific Island men (9/100,000), a rare example of divergence between these two populations in terms of the incidence of any disease (cancer or otherwise). Our observations beg the following questions: first, why are rates of testicular germ cell tumour so much higher among Māori New Zealanders compared to the already high rates observed among European/Other New Zealanders? Second, why are rates of testicular germ cell tumour so completely divergent between Māori and Pacific New Zealanders, when these two groups typically move in parallel with respect to the incidence of given diseases? Finally, what might we learn about the factors that cause testicular germ cell tumour in general by answering these questions? CONCLUSION This review examines the possible drivers of our observed disparity, discusses their feasibility, and highlights new work that is underway to further understand these drivers.
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Affiliation(s)
- J K Gurney
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
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Levine H, Keinan-Boker L, Leiba A, Derazne E, Rais A, Kark JD. Paternal age and risk of testicular germ cell tumors: a cohort study of 1,000,000 men. Andrology 2017; 5:1124-1130. [PMID: 28950439 DOI: 10.1111/andr.12422] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/28/2017] [Accepted: 08/01/2017] [Indexed: 01/12/2023]
Abstract
Testicular germ cell tumors (TGCT) are the most frequent cancer among young men, with increasing incidence worldwide. Advanced paternal age has been linked to adverse health outcomes in offspring, but reports on the association of paternal age with TGCT are few and inconsistent. We aimed to examine the relationship of paternal age (PAB) at birth with the risk of TGCT and by histologic type: seminoma and non-seminoma. A population-based cohort of 1,056,058 males, examined at ages 16-19 between the years 1980-2011, was linked to the Israel National Cancer Registry to obtain incident TGCT through 2012. We applied multivariable Cox regression. During 16.5 million person-years of follow-up, 1247 incident cases (604 seminomas and 643 non-seminomas) were detected. Increasing PAB was linearly associated with lower risk of TGCT (HRper year = 0.983, 95% CI: 0.974-0.993, p = 0.001), after adjustment for year of birth, years of education, height, cryptorchidism history and origin, and also with additional adjustment for maternal age at birth (MAB) (HRper year = 0.980: 0.965-0.995, p = 0.008). The association was stronger for seminoma (HRper year = 0.968: 0.946-0.989, p = 0.004) and persisted in a subset adjusted for sibship size (HRper year = 0.950: 0.917-0.983, p = 0.003). In the fully adjusted model, young PAB (15-24 vs. ≥30) was a risk factor for seminoma (HR = 1.41: 1.07-1.85, p = 0.014). In models adjusted for PAB, MAB was not associated with risk of TGCT. In conclusion, our findings suggest that young paternal age is a risk factor of TGCT, especially seminoma. The findings warrant further investigation into the possible impact of young paternal age on their offsprings' testes.
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Affiliation(s)
- H Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - L Keinan-Boker
- The National Cancer Registry, Israel Center for Disease Control, Jerusalem, Israel.,School of Public Health, University of Haifa, Haifa, Israel
| | - A Leiba
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Institute of Nephrology and Hypertension, Sheba Medical Center, Tel Hashomer, Israel
| | - E Derazne
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - A Rais
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - J D Kark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
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Pelloni M, Coltrinari G, Paoli D, Pallotti F, Lombardo F, Lenzi A, Gandini L. Differential expression of miRNAs in the seminal plasma and serum of testicular cancer patients. Endocrine 2017; 57:518-527. [PMID: 27796811 DOI: 10.1007/s12020-016-1150-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/17/2016] [Indexed: 02/07/2023]
Abstract
Various microRNAs from the miR-371-3 and miR-302a-d clusters have recently been proposed as markers for testicular germ cell tumours. Upregulation of these miRNAs has been found in both the tissue and serum of testicular cancer patients, but they have never been studied in human seminal plasma. The aim of this study was, therefore, to assess the differences in the expression of miR-371-3 and miR-302a-d between the seminal plasma and serum of testicular cancer patients, and to identify new potential testicular cancer markers in seminal plasma. We investigated the serum and seminal plasma of 28 pre-orchiectomy patients subsequently diagnosed with testicular cancer, the seminal plasma of another 20 patients 30 days post-orchiectomy and a control group consisting of 28 cancer-free subjects attending our centre for an andrological check-up. Serum microRNA expression was analysed using RT-qPCR. TaqMan Array Card 3.0 platform was used for microRNA profiling in the seminal plasma of cancer patients. Results for both miR-371-3 and the miR-302 cluster in the serum of testicular cancer patients were in line with literature reports, while miR-371and miR-372 expression in seminal plasma showed the opposite trend to serum. On array analysis, 37 miRNAs were differentially expressed in the seminal plasma of cancer patients, and the upregulated miR-142 and the downregulated miR-34b were validated using RT-qPCR. Our study investigated the expression of miRNAs in the seminal plasma of patients with testicular cancer for the first time. Unlike in serum, miR-371-3 cannot be considered as markers in seminal plasma, whereas miR-142 levels in seminal plasma may be a potential marker for testicular cancer.
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Affiliation(s)
- Marianna Pelloni
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
| | - Giulia Coltrinari
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
| | - Donatella Paoli
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy.
| | - Francesco Pallotti
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
| | - Francesco Lombardo
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
| | - Andrea Lenzi
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
| | - Loredana Gandini
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Roma, Italy
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Ghazarian AA, Kelly SP, Altekruse SF, Rosenberg PS, McGlynn KA. Future of testicular germ cell tumor incidence in the United States: Forecast through 2026. Cancer 2017; 123:2320-2328. [PMID: 28241106 PMCID: PMC5629636 DOI: 10.1002/cncr.30597] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND Testicular germ cell tumors (TGCTs) are rare tumors in the general population but are the most commonly occurring malignancy among males between ages 15 and 44 years in the United States (US). Although non-Hispanic whites (NHWs) have the highest incidence in the US, rates among Hispanics have increased the most in recent years. To forecast what these incidence rates may be in the future, an analysis of TGCT incidence in the Surveillance, Epidemiology, and End Results program and the National Program of Cancer Registries was conducted. METHODS TGCT incidence data among males ages 15 to 59 years for the years 1999 to 2012 were obtained from 39 US cancer registries. Incidence rates through 2026 were forecast using age-period-cohort models stratified by race/ethnicity, histology (seminoma, nonseminoma), and age. RESULTS Between 1999 and 2012, TGCT incidence rates, both overall and by histology, were highest among NHWs, followed by Hispanics, Asian/Pacific Islanders, and non-Hispanic blacks. Between 2013 and 2026, rates among Hispanics were forecast to increase annually by 3.96% (95% confidence interval, 3.88%-4.03%), resulting in the highest rate of increase of any racial/ethnic group. By 2026, the highest TGCT rates in the US will be among Hispanics because of increases in both seminomas and nonseminomas. Rates among NHWs will slightly increase, whereas rates among other groups will slightly decrease. CONCLUSIONS By 2026, Hispanics will have the highest rate of TGCT of any racial/ethnic group in the US because of the rising incidence among recent birth cohorts. Reasons for the increase in younger Hispanics merit further exploration. Cancer 2017;123:2320-2328. © 2017 American Cancer Society.
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Affiliation(s)
- Armen A. Ghazarian
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Scott P. Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Sean F. Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Philip S. Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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12
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van Leeuwen MT, Gurney H, Turner JJ, Turner SL, Pearson SA, Laaksonen MA, Harnett P, Balakrishnar B, Sabanathan D, Vajdic CM. Patterns and trends in the incidence of paediatric and adult germ cell tumours in Australia, 1982–2011. Cancer Epidemiol 2016; 43:15-21. [DOI: 10.1016/j.canep.2016.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/03/2016] [Accepted: 05/08/2016] [Indexed: 02/02/2023]
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Znaor A, Lortet-Tieulent J, Laversanne M, Jemal A, Bray F. International testicular cancer incidence trends: generational transitions in 38 countries 1900-1990. Cancer Causes Control 2015; 26:151-8. [PMID: 25388800 DOI: 10.1007/s10552-014-0486-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 10/27/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE Rapid increases in testicular cancer incidence have marked the second half of the last century. While these secular rises, observed mainly in countries attaining the highest levels of human development, appear to have attenuated in the last decade, rates continue to increase in countries transiting toward high developmental levels. The purpose of our study was to provide a comprehensive analysis and presentation of the cohort-specific trends in testicular cancer incidence rates in 38 countries worldwide. METHODS We used an augmented version of the Cancer Incidence in Five Continents series to analyze testicular cancer incidence in men aged 15-54 in 38 countries, via age-period-cohort analysis. RESULTS In many European countries, the USA, Canada, Australia, and New Zealand, there is a continuation of the increasing risk among successive generations, yet rates are attenuating in male cohorts born since the 1970s in several Northern European countries, in contrast to the steeply increasing trends in recent cohorts in Southern Europe. Incidence rates have also been increasing in the populations traditionally at rather low risk, such as in the Philippines, Singapore, China, and Costa Rica. CONCLUSIONS The attenuation of testicular cancer risk in younger generations (in the most developed countries) alongside concomitant increases (in countries undergoing developmental change) is indicative of a global transition in the risk of testicular cancer. While identifying the underlying causes remains a major challenge, increasing awareness and adapting national healthcare systems to accommodate a growing burden of testicular cancer may prevent future avoidable deaths in young men.
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Affiliation(s)
- Ariana Znaor
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372, Lyon, Cedex 08, France,
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14
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Rosenberg PS, Check DP, Anderson WF. A web tool for age-period-cohort analysis of cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev 2014; 23:2296-302. [PMID: 25146089 DOI: 10.1158/1055-9965.epi-14-0300] [Citation(s) in RCA: 280] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. METHODS We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly Web tool. RESULTS Input data for the Web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates, period and cohort rate ratios that incorporate the overall annual percentage change (net drift), and estimators of the age-specific annual percentage change (local drifts). The Web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value file. Model outputs can be saved in a variety of formats, including R and Excel. CONCLUSIONS APC methodology can now be carried out through a freely available user-friendly Web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. IMPACT The Web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland.
| | - David P Check
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland
| | - William F Anderson
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland
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Béranger R, Pérol O, Bujan L, Faure E, Blain J, Cornet CL, Flechon A, Charbotel B, Philip T, Schüz J, Fervers B. Studying the impact of early life exposures to pesticides on the risk of testicular germ cell tumors during adulthood (TESTIS project): study protocol. BMC Cancer 2014; 14:563. [PMID: 25095793 PMCID: PMC4129121 DOI: 10.1186/1471-2407-14-563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/22/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The incidence of testicular germ cell tumors (TGCT), the most common cancer in men aged 15 to 45 years, has doubled over the last 30 years in developed countries. Reasons remain unclear but a role of environmental factors, especially during critical periods of development, is strongly suspected. Reliable data on environmental exposure during this critical time period are sparse. Little is known on whether it could be a combined effect of early and later-life exposures. METHODS/DESIGN Our research aims to study the association between TGCT risk and pesticide exposures (domestic, occupational and environmental) during critical time periods of development and combined early and later-life exposures. The study design, developed during a 2-year pilot study, is a multicenter case-control study of 500 cases (ascertained through histology) and 1000 fertile/fecund controls recruited through 21 French 'Centres d'Etude et de Conservation des Œufs et de Sperme humain' (CECOS). Trained professional interviewers interview the subjects and their mothers by phone. Using a geographic information system developed and tested for application in this study design, environmental pesticides exposure assessment is based on life-time residential history. Occupational pesticides exposures are assessed by an industrial hygienist based on parents' occupations and tasks. Exposures during the prenatal period, early childhood and puberty are focused. A blood sample is collected from each participant to assess genetic polymorphisms known to be associated with TGCT risk, as well as to explore gene-environment interactions. DISCUSSION The results of our study will contribute to better understanding the causes of TGCT and the rapid increase of its incidence. We explore the effect of combined early and later-life pesticides exposure from multiple sources, as well as potential gene-environment interactions that have until now been rarely studied for TGCT. Our design allows future pooled studies and the bio-bank allows additional genetic or toxicological analyses.
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Affiliation(s)
- Rémi Béranger
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
- />Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
- />EAM 4128 “Santé Individu Société”, Université Claude Bernard – Lyon 1, Villeurbanne, France
| | - Olivia Pérol
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
| | - Louis Bujan
- />Hôpital Paule de Viguier; Fédération Française des CECOS, CECOS, CHU, Toulouse, France
- />Université de Toulouse; UPS; Groupe de recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), Toulouse, France
| | - Elodie Faure
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
| | - Jeffrey Blain
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
| | - Charlotte Le Cornet
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
- />Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Aude Flechon
- />Centre de Lutte Contre le Cancer, Centre Léon Bérard, Lyon, France
| | - Barbara Charbotel
- />Université de Lyon, F-69003 Lyon, France
- />Université Lyon 1, UMRESTTE (Unité mixte IFSTTAR/UCBL), Domaine Rockefeller, 69373 Lyon, France
| | - Thierry Philip
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
| | - Joachim Schüz
- />Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Béatrice Fervers
- />Unité Cancer et Environnement, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, 08 Cedex, France
- />EAM 4128 “Santé Individu Société”, Université Claude Bernard – Lyon 1, Villeurbanne, France
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Bhatti ABH, Ahmed I, Ghauri RK, Saeed Q, Mir K. Clinical profile, treatment and survival outcome of testicular tumors: a pakistani perspective. Asian Pac J Cancer Prev 2014; 15:277-80. [PMID: 24528039 DOI: 10.7314/apjcp.2014.15.1.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Testicular cancer management is considered a marvel of modern science with excellent treatment results. Pakistan has a distinct ethnic variation and geographic distribution but data regarding clinical presentation of testicular tumors and their management is under reported. The objective of this study was to determine clinical profile, treatment modalities and survival outcome of testicular tumors in the Pakistani population. MATERIALS AND METHODS A retrospective review of patients who received treatment for testicular cancer at Shaukat Khanum Cancer Hospital from January 2009 to December 2012 was performed. Patient demographics, clinical features at presentation and treatment modalities were assessed. For categorical variables chi square test was used. Survival was calculated using Kaplan Meier survival curves and Log rank test was employed to determine significance. RESULTS The most common tumor was mixed germ cell tumor in 49% patients. For all tumor variants except seminoma, stage III was the most common clinical stage at presentation. Majority of patients with non seminomatous germ cell tumors presented in the15-30 year age group as compared to seminoma which was most prevalent in the 30-40 year age group. Orchiectomy followed by chemotherapy was the most common treatment modality in 80% patients. Expected 5 year survival for seminomas and non- seminomatous germ cell tumors was 96% and 90% respectively which was not significantly different (p=0.2). CONCLUSIONS Despite a distinct clinical profile of testicular tumors in Pakistani population, survival is comparable with published reports.
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Affiliation(s)
- Abu Bakar Hafeez Bhatti
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan E-mail :
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McKinnell C, Mitchell RT, Morris K, Anderson RA, Kelnar CJH, Wallace WH, Sharpe RM. Perinatal germ cell development and differentiation in the male marmoset (Callithrix jacchus): similarities with the human and differences from the rat. Hum Reprod 2013; 28:886-96. [PMID: 23321215 PMCID: PMC3600838 DOI: 10.1093/humrep/des465] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
STUDY QUESTION Is perinatal germ cell (GC) differentiation in the marmoset similar to that in the human? SUMMARY ANSWER In a process comparable with the human, marmoset GC differentiate rapidly after birth, losing OCT4 expression after 5–7 weeks of age during mini-puberty. WHAT IS KNOWN ALREADY Most of our understanding about perinatal GC development derives from rodents, in which all gonocytes (undifferentiated GC) co-ordinately lose expression of the pluripotency factor OCT4 and stop proliferating in late gestation. Then after birth these differentiated GC migrate to the basal lamina and resume proliferation prior to the onset of spermatogenesis. In humans, fetal GC differentiation occurs gradually and asynchronously and OCT4+ GC persist into perinatal life. Failure to switch off OCT4 in GC perinatally can lead to development of carcinoma in situ (CIS), the precursor of testicular germ cell cancer (TGCC), for which there is no animal model. Marmosets show similarities to the human, but systematic evaluation of perinatal GC development in this species is lacking. Similarity, especially for loss of OCT4 expression, would support use of the marmoset as a model for the human and for studying CIS origins. STUDY DESIGN, SIZE AND DURATION Testis tissues were obtained from marmosets (n = 4–10 per age) at 12–17 weeks' gestation and post-natal weeks 0.5, 2.5, 5–7, 14 and 22 weeks, humans at 15–18 weeks' gestation (n = 5) and 4–5 weeks of age (n = 4) and rats at embryonic day 21.5 (e21.5) (n = 3) and post-natal days 4, 6 and 8 (n = 4 each). PARTICIPANTS/MATERIALS, SETTING AND METHODS Testis sections from fetal and post-natal marmosets, humans and rats were collected and immunostained for OCT4 and VASA to identify undifferentiated and differentiated GC, respectively, and for Ki67, to identify proliferating GC. Stereological quantification of GC numbers, differentiation (% OCT4+ GC) and proliferation were performed in perinatal marmosets and humans. Quantification of GC position within seminiferous cords was performed in marmosets, humans and rats. MAIN RESULTS AND ROLE OF CHANCE The total GC number increased 17-fold from birth to 22 post-natal weeks in marmosets; OCT4+ and VASA+ GC proliferated equally in late gestation and early post-natal life. The percentage of OCT4+ GC fell from 54% in late fetal life to <0.5% at 2.5 weeks of age and none were detected after 5–7 weeks in marmosets. In humans, the percentage of OCT4+ GC also declined markedly during the equivalent period. In marmosets, GC had begun migrating to the base of seminiferous cords at ∼22 weeks of age, after the loss of GC OCT4 expression. LIMITATIONS, REASONS FOR CAUTION There is considerable individual variation between marmosets. Although GC development in marmosets and humans was similar, there are differences with respect to proliferation during fetal life. The number of human samples was limited. WIDER IMPLICATIONS OF THE FINDINGS The similarities in testicular GC differentiation between marmosets and humans during the perinatal period, and their differences from rodents, suggest that the marmoset may be a useful model for studying the origins of CIS, with relevance for the study of TGCC. STUDY FUNDING/COMPETING INTERESTS This work was supported by Grant G33253 from the Medical Research Council, UK. No external funding was sought and there are no competing interests.
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Affiliation(s)
- Chris McKinnell
- MRC/University of Edinburgh Centre for Reproductive Health, The Queen's Medical Research Institute, Edinburgh, UK.
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Rosenberg PS, Wilson KL, Anderson WF. Are incidence rates of adult leukemia in the United States significantly associated with birth cohort? Cancer Epidemiol Biomarkers Prev 2012; 21:2159-66. [PMID: 23064005 DOI: 10.1158/1055-9965.epi-12-0910] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Leukemia is a common cancer among U.S. adults but there are few established risk factors. If leukemia risks are substantially influenced by exposures that vary in prevalence across generations, then population incidence rates should vary significantly by birth cohort. However, prior studies have not examined leukemia birth cohort effects using contemporary data and methods. METHODS We used incidence data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program from 1992 through 2009 for adults 25-84 years old and age period cohort models to estimate incidence rate ratios according to birth cohort for acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphoid leukemia (CLL). RESULTS Leukemia incidence varied significantly between birth cohorts for each major leukemia type in men and women except female AMLs; changes on the order of 1% per birth year or 20% per generation were observed. The most significant birth cohort signatures were observed for CLLs and AMLs in men, which were decreasing and increasing, respectively, in cohorts born since 1946. CONCLUSIONS Our results support the hypothesis that adult leukemia risks are significantly modulated by environmental and lifestyle exposures. IMPACT A number of well-established (smoking, certain chemicals, radiation) and newly recognized (obesity) leukemia risk factors are modifiable; ultimately, efforts to promote healthy lifestyles might also help reduce incidence rates of adult leukemia.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Executive Plaza South, Room 8022, Rockville, MD 20852, USA.
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Speaks C, McGlynn KA, Cook MB. Significant calendar period deviations in testicular germ cell tumors indicate that postnatal exposures are etiologically relevant. Cancer Causes Control 2012; 23:1593-8. [PMID: 22941667 PMCID: PMC3461587 DOI: 10.1007/s10552-012-0036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 07/17/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE The current working model of type II testicular germ cell tumor (TGCT) pathogenesis states that carcinoma in situ arises during embryogenesis, is a necessary precursor, and always progresses to cancer. An implicit condition of this model is that only in utero exposures affect the development of TGCT in later life. In an age-period-cohort analysis, this working model contends an absence of calendar period deviations. We tested this contention using data from the SEER registries of the United States. METHODS We assessed age-period-cohort models of TGCTs, seminomas, and nonseminomas for the period 1973-2008. Analyses were restricted to whites diagnosed at ages 15-74 years. We tested whether calendar period deviations were significant in TGCT incidence trends adjusted for age deviations and cohort effects. RESULTS This analysis included 32,250 TGCTs (18,475 seminomas and 13,775 nonseminomas). Seminoma incidence trends have increased with an average annual percentage change in log-linear rates (net drift) of 1.25 %, relative to just 0.14 % for nonseminoma. In more recent time periods, TGCT incidence trends have plateaued and then undergone a slight decrease. Calendar period deviations were highly statistically significant in models of TGCT (p = 1.24(-9)) and seminoma (p = 3.99(-14)), after adjustment for age deviations and cohort effects; results for nonseminoma (p = 0.02) indicated that the effects of calendar period were much more muted. CONCLUSION Calendar period deviations play a significant role in incidence trends of TGCT, which indicates that postnatal exposures are etiologically relevant.
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Affiliation(s)
- Crystal Speaks
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Levine H, Afek A, Shamiss A, Derazne E, Tzur D, Zavdy O, Barchana M, Kark JD. Risk of germ cell testicular cancer according to origin: a migrant cohort study in 1,100,000 Israeli men. Int J Cancer 2012; 132:1878-85. [PMID: 22961361 DOI: 10.1002/ijc.27825] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/23/2012] [Indexed: 11/05/2022]
Abstract
Testicular cancer incidence is highest among men of northern European ancestry and lowest among men of Asian/African descent. We conducted a large-scale migrant cohort study to assess origin and migrant generation as predictors of testicular germ cell tumors (TGCTs), controlling for possible confounders. Data on 1,092,373 Jewish Israeli males, who underwent a general health examination prior to compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident TGCTs up to 2006. Cox proportional hazards was used to model time to event. Overall, 1,001 incident cases (534 seminoma and 467 nonseminoma) were detected during 19.2 million person-years of follow-up. Origin was a strong independent predictor of TGCTs with remarkably low incidence for North African-born (HR = 0.10, 95% CI: 0.04-0.21) and Asian-born (HR = 0.35, 0.20-0.62), while intermediate for Israeli-born of North African origin (HR = 0.48, 0.40-0.58) and Asian origin (HR = 0.56, 0.47-0.66), compared to European origin. A comparison of Israeli born of North African and Asian origin with North African and Asian-born yielded a HR of 2.31 (1.36-3.93). Significant risk factors controlled for were year of birth, years of education and height. Findings persisted when analyses were stratified by histologic subtypes of TGCTs. The findings of lower rates of TGCTs among men born in North Africa and Asia compared to European ancestry, but a steep increase in next generation migrants, particularly among the Israeli-born migrants from North Africa, provide clues to direct further research on the role of modern lifestyle and environment in the etiology of TGCTs.
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Affiliation(s)
- Hagai Levine
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel.
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Milia-Argeiti E, Huet E, Labropoulou VT, Mourah S, Fenichel P, Karamanos NK, Menashi S, Theocharis AD. Imbalance of MMP-2 and MMP-9 expression versus TIMP-1 and TIMP-2 reflects increased invasiveness of human testicular germ cell tumours. ACTA ACUST UNITED AC 2012; 35:835-844. [PMID: 22712465 DOI: 10.1111/j.1365-2605.2012.01289.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The histological classification of testicular germ cell tumours (TGCTs) to seminoma or non-seminomatous germ cell tumours is at present the main criterion for the clinical outcome and selection of the treatment strategy. In view of the need to identify novel prognostic biomarkers for TGCTs, we investigated the expression of the matrix metalloproteinases MMP-2 and MMP-9 in testicular tumour tissues and cell lines of both seminoma and non-seminoma origin. Immunohistochemistry and zymography analysis of tumoural tissues showed significantly higher levels of MMP-2 and MMP-9 compared with normal testis with the active forms detected only in the tumour tissues. Three cell lines representative of the different tumour types, JKT-1 seminoma, NCCIT teratocarcinoma and NTERA2/D1 embryonal carcinoma were also evaluated for their expression of these MMPs using qPCR and zymography and for their invasive properties. The more invasive non-seminomatous teratocarcinoma and embryonal cells expressed considerably more MMP-2 and MMP-9 compared with seminoma cells exhibiting lower invasiveness. Furthermore, an inverse relation was observed between invasiveness and the expression of endogenous inhibitors TIMP-1 and TIMP-2. The MMP inhibitor Marimastat inhibited invasion in all cell lines, the highest inhibition was observed in the more invasive NTERA2/D1 and NCCIT cells, which presented the highest ratio of MMP-2 and MMP-9 vs. TIMP-1 and TIMP-2. These results highlight the importance of MMP-2 and MMP-9 in the invasiveness of testicular tumours and suggest that their levels, vs. those of TIMP-1 and TIMP-2, may represent potential biomarkers for testicular malignancy.
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Affiliation(s)
- E Milia-Argeiti
- Department of Chemistry, Laboratory of Biochemistry, University of Patras, Greece
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Kristiansen W, Andreassen K, Karlsson R, Aschim E, Bremnes R, Dahl O, Fosså S, Klepp O, Langberg C, Solberg A, Tretli S, Adami HO, Wiklund F, Grotmol T, Haugen T. Gene variations in sex hormone pathways and the risk of testicular germ cell tumour: a case–parent triad study in a Norwegian–Swedish population. Hum Reprod 2012; 27:1525-35. [DOI: 10.1093/humrep/des075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Sincic N, Kulis T, Znaor A, Bray F. Time trends in testicular cancer in Croatia 1983–2007: Rapid increases in incidence, no declines in mortality. Cancer Epidemiol 2012; 36:11-5. [DOI: 10.1016/j.canep.2011.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 09/22/2011] [Accepted: 09/27/2011] [Indexed: 11/29/2022]
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Rosenberg PS, Anderson WF. Age-period-cohort models in cancer surveillance research: ready for prime time? Cancer Epidemiol Biomarkers Prev 2011; 20:1263-8. [PMID: 21610223 PMCID: PMC3132831 DOI: 10.1158/1055-9965.epi-11-0421] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Standard descriptive methods for the analysis of cancer surveillance data include canonical plots based on the lexis diagram, directly age-standardized rates (ASR), estimated annual percentage change (EAPC), and joinpoint regression. The age-period-cohort (APC) model has been used less often. Here, we argue that it merits much broader use. First, we describe close connections between estimable functions of the model parameters and standard quantities such as the ASR, EAPC, and joinpoints. Estimable functions have the added value of being fully adjusted for period and cohort effects, and generally more precise. Second, the APC model provides the descriptive epidemiologist with powerful new tools, including rigorous statistical methods for comparative analyses, and the ability to project the future burden of cancer. We illustrate these principles by using invasive female breast cancer incidence in the United States, but these concepts apply equally well to other cancer sites for incidence or mortality.
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Stang A, Kuss O. Etiologic Differences Between Seminoma and Nonseminoma of the Testis: A Systematic Review of Epidemiologic Studies. Hematol Oncol Clin North Am 2011; 25:473-86, vii. [DOI: 10.1016/j.hoc.2011.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Alam SS, Cantwell MM, Cardwell CR, Cook MB, Murray LJ. Maternal body mass index and risk of testicular cancer in male offspring: a systematic review and meta-analysis. Cancer Epidemiol 2010; 34:509-15. [PMID: 20800565 DOI: 10.1016/j.canep.2010.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 07/01/2010] [Accepted: 07/02/2010] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To date a number of studies have examined the association between maternal weight and testicular cancer risk although results have been largely inconsistent. This systematic review and meta-analysis investigated the nature of this association. METHODS Search strategies were conducted in Ovid Medline (1950-2009), Embase (1980-2009), Web of Science (1970-2009), and CINAHL (1937-2009) using keywords for maternal weight (BMI) and testicular cancer. RESULTS The literature search produced 1689 hits from which 63 papers were extracted. Only 7 studies met the pre-defined criteria. Random effects meta-analyses were conducted. The combined unadjusted OR (95% CI) of testicular cancer in the highest reported category of maternal BMI compared with the moderate maternal BMI was 0.82 (0.65-1.02). The Cochran's Q P value was 0.82 and the corresponding I(2) was 0%, both indicating very little variability among studies. The combined unadjusted OR (95% CI) for testicular cancer risk in the lowest reported category of maternal BMI compared to a moderate maternal BMI category was 0.88 (0.65-1.20). The Cochran's Q P value was 0.05 and the corresponding I(2) was 54%, indicating evidence of statistical heterogeneity. The combined unadjusted OR (95% CI) of testicular cancer risk per unit increase in maternal BMI was 1.01 (0.97-1.06). The Cochran's Q test had a P value of 0.05 and the corresponding I(2) was 55% indicating evidence of statistical heterogeneity. CONCLUSION This meta-analysis, which included a small number of studies, showed that a higher maternal weight does not increase the risk of testicular cancer in male offspring. Though an inverse association between high maternal BMI and testicular cancer risk was detected, it was not statistically significant. Further primary studies with adjustment for appropriate confounders are required.
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Affiliation(s)
- Shama S Alam
- Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom.
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Rosenberg PS, Anderson WF. Proportional hazards models and age-period-cohort analysis of cancer rates. Stat Med 2010; 29:1228-38. [PMID: 20209480 DOI: 10.1002/sim.3865] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Age-period-cohort (APC) analysis is widely used in cancer epidemiology to model trends in cancer rates. We develop methods for comparative APC analysis of two independent cause-specific hazard rates assuming that an APC model holds for each one. We construct linear hypothesis tests to determine whether the two hazards are absolutely proportional or proportional after stratification by cohort, period, or age. When a given proportional hazards model appears adequate, we derive simple expressions for the relative hazards using identifiable APC parameters. To demonstrate the utility of these new methods, we analyze cancer incidence rates in the United States in blacks versus whites for selected cancers, using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The examples illustrate that each type of proportionality may be encountered in practice.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20852-7244, USA.
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Chia VM, Quraishi SM, Devesa SS, Purdue MP, Cook MB, McGlynn KA. International trends in the incidence of testicular cancer, 1973-2002. Cancer Epidemiol Biomarkers Prev 2010; 19:1151-9. [PMID: 20447912 DOI: 10.1158/1055-9965.epi-10-0031] [Citation(s) in RCA: 205] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Whereas testicular cancer incidence rates have been widely reported in populations of Northern European ancestry, rates in other populations have been less frequently examined. In a prior report, global testicular cancer incidence rates and trends for the years 1973 to 1997 were summarized. The current report extends these analyses with an additional 5 years of data from Cancer Incidence in Five Continents. METHODS Age-standardized incidence rates over successive 5-year time periods were obtained for populations in the Americas, Asia, Europe, and Oceania. RESULTS In general, testicular cancer incidence remained highest in Northern European populations (8.0-9.0 per 100,000) and lowest in Asian and African populations (<1 per 100,000). One notable exception to this pattern, however, was the very high rate reported by the Valdivia, Chile registry (8.8 per 100,000). In many populations, rates rose between 1973 and 2002, although the increases were strongest and most consistent among populations of European ancestry. In certain European populations, such as those of Denmark and of Geneva, Switzerland, some recent plateauing of rates was evident. There was little evidence of increase and possible evidence of a modest decline in rates among east Asian populations. Trends by histology (seminoma and nonseminoma) were generally similar to one another. CONCLUSIONS Risk of testicular cancer remains relatively high in Northern European populations and low in Asian and African populations. Similar trends by histology suggest common risk factors. EFFECT: Reasons for increasing rates among Northern Europeans and stable or declining rates among East Asians are unexplained, supporting the need for future etiologic studies.
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Affiliation(s)
- Victoria M Chia
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS/Suite 550, 6120 Executive Boulevard, Rockville, MD 20892-7234, USA
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Hemminki K, Liu H, Sundquist J. Second cancers after testicular cancer diagnosed after 1980 in Sweden. Ann Oncol 2010; 21:1546-1551. [DOI: 10.1093/annonc/mdp562] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liu H, Sundquist J, Hemminki K. Understanding the agreement of histology of familial testicular tumors. Urol Oncol 2010; 28:465. [PMID: 20483642 DOI: 10.1016/j.urolonc.2009.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 12/11/2009] [Indexed: 11/18/2022]
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Liu H, Sundquist J, Hemminki K. Re: Multifocality in testicular germ cell tumors Y. Ehrlich, M. Konichezky, O. Yossepowitch and J. Baniel J Urol 2009, 181: 1114-1120. J Urol 2010; 183:2467-8. [PMID: 20417527 DOI: 10.1016/j.juro.2010.02.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Indexed: 11/17/2022]
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Beiki O, Granath F, Allebeck P, Akre O, Moradi T. Subtype-Specific Risk of Testicular Tumors among Immigrants and Their Descendants in Sweden, 1960 to 2007. Cancer Epidemiol Biomarkers Prev 2010; 19:1053-65. [DOI: 10.1158/1055-9965.epi-09-1190] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Seseke S, Bierwirth S, Strauss A, Ringert RH, Seseke F. Long-term clinical outcome in patients with stage-I nonseminomatous germ cell cancer. A critical review of own treatment modalities in a retrospective study. Int Braz J Urol 2009; 34:715-22; discussion 723-4. [PMID: 19111076 DOI: 10.1590/s1677-55382008000600006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2008] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The optimal management of patients with clinical stage I non-seminomatous germ cell testicular cancer (NSGCT I) was considered controversial until the European Germ Cell Cancer Consensus Group determined unambiguous treatment strategies. In order to assess the long-term outcome we evaluated the data of patients with NSGCT I. MATERIALS AND METHODS In a retrospective evaluation, we included 52 patients with a mean age of 26 years (range 15-58) who were treated with different modalities at our department between 1989 and 2003. Mean follow-up was 5.9 years (range 2-14 years). After orchiectomy, 39 patients were treated with chemotherapy, 7 patients underwent retroperitoneal lymph node dissection and 6 men were managed using a surveillance strategy. Survival, recurrence rate and time of recurrence were evaluated. The histological staging and treatment modality was related to the relapse. RESULTS Tumor specific overall mortality was 3.8%. The mortality and relapse rate of the surveillance strategy, retroperitoneal lymph node dissection and chemotherapy was 16.7% / 50%, 14.3% / 14.3% and 0% / 2.5% respectively. All relapsed patients in the surveillance group as well as in the RPLND group had at least one risk factor for developing metastatic disease. CONCLUSIONS Following the European consensus on diagnosis and treatment of germ cell cancer in patients with NSGCT Stage I any treatment decision must be individually related to the patient according to prognostic factors and care capacity of the treating centre. In case of doubt, adjuvant chemotherapy should be the treatment of choice, as it provides the lowest risk of relapse or tumor related death.
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Affiliation(s)
- Sandra Seseke
- Department of Urology, Georg-August-University, Gottingen, Germany.
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Lacerda HM, Akre O, Merletti F, Richiardi L. Time trends in the incidence of testicular cancer in childhood and young adulthood. Cancer Epidemiol Biomarkers Prev 2009; 18:2042-5. [PMID: 19531675 DOI: 10.1158/1055-9965.epi-08-1140] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There has been a steep increase in the incidence of adult testicular cancer in many populations, but in spite of numerous studies, the etiology of testicular cancer remains elusive. The time trends of childhood testicular tumors are less clear and have been studied in a few populations. To further evaluate whether or not adult and childhood cancers share trend determinants and whether future adult testicular cancer incidences can be predicted through childhood testicular cancer incidences, their rates were compared. METHOD Data on testicular cancer incidence in childhood and in young adulthood were extracted from the IARC Cancer Incidence in the Five Continents Database limited to two 10-year time periods (1967-1976 and from 1987-1996) to allow for truncation-free analyses within the same birth cohort. RESULTS Childhood testicular cancer incidence varied 3- to 4-fold, whereas adult testicular cancer incidence varied 10- to 11-fold between the studied populations. No positive correlation between childhood and adulthood incidence of testicular cancer was found. CONCLUSION These data indicate that the incidence of testicular cancer in adulthood is influenced by factors, either prenatal or postnatal exposures different than those determining the trends among children.
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Daling JR, Doody DR, Sun X, Trabert BL, Weiss NS, Chen C, Biggs ML, Starr JR, Dey SK, Schwartz SM. Association of marijuana use and the incidence of testicular germ cell tumors. Cancer 2009; 115:1215-23. [PMID: 19204904 DOI: 10.1002/cncr.24159] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The incidence of testicular germ cell tumors (TGCTs) has been increasing the past 4 to 6 decades; however, exposures that account for this rise have not been identified. Marijuana use also grew during the same period, and it has been established that chronic marijuana use produces adverse effects on the human endocrine and reproductive systems. In this study, the authors tested the hypothesis that marijuana use is a risk factor for TGCT. METHODS A population-based, case-control study of 369 men ages 18 to 44 years who were diagnosed with TGCT from January 1999 through January 2006 was conducted in King, Pierce and Snohomish Counties in Washington State. The responses of these men to questions on their lifetime marijuana use were compared with the responses of 979 age-matched controls who resided in the same 3 counties during the case diagnosis period. RESULTS Men with a TGCT were more likely to be current marijuana smokers at the reference date compared with controls (odds ratio [OR], 1.7; 95% confidence interval [95% CI], 1.1-2.5). In analyses according to histologic type, most of the association between current marijuana use and TGCT was observed in men who had nonseminomas/mixed histology tumors (current use: OR, 2.3; 95% CI, 1.3-4.0). Age at first use among current users (age<18 years [OR, 2.8] vs age>or=18 years [OR, 1.3]) and frequency of use (daily or weekly [OR, 3.0] vs less than once per week [OR, 1.8]) appeared to modify the risk. CONCLUSIONS An association was observed between marijuana use and the occurrence of nonseminoma TGCTs. Additional studies of TGCTs will be needed to test this hypothesis, including molecular analyses of cannabinoid receptors and endocannabinoid signaling, which may provide clues regarding the biologic mechanisms of TGCTs.
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Affiliation(s)
- Janet R Daling
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
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Stang A. Etiology of testicular germ cell tumors: lumping or splitting? A plea against lumping. Eur J Epidemiol 2008; 24:65-7. [DOI: 10.1007/s10654-008-9311-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 12/10/2008] [Indexed: 10/21/2022]
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Testicular sperm extraction in a single cancerous testicle in patients with azoospermia: a case report. Fertil Steril 2008; 90:443.e1-4. [DOI: 10.1016/j.fertnstert.2007.07.1308] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Revised: 06/12/2007] [Accepted: 07/10/2007] [Indexed: 11/18/2022]
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Cook MB, Sigurdson AJ, Jones IM, Thomas CB, Graubard BI, Korde L, Greene MH, McGlynn KA. Endogenous DNA damage and testicular germ cell tumors. ACTA ACUST UNITED AC 2008; 32:599-606. [PMID: 18657195 DOI: 10.1111/j.1365-2605.2008.00905.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Testicular germ cell tumors are comprised of two histologic groups, seminomas and non-seminomas. We postulated that the possible divergent pathogeneses of these histologies may be partially explained by variable levels of net endogenous DNA damage. To test our hypothesis, we conducted a case-case analysis of 51 seminoma and 61 non-seminoma patients using data and specimens from the Familial Testicular Cancer study and the U.S. Radiologic Technologists cohort. A lymphoblastoid cell line was cultured for each patient and the alkaline comet assay was used to determine four parameters: tail DNA, tail length, comet distributed moment (CDM) and Olive tail moment (OTM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression. Values for tail length, tail DNA, CDM and OTM were modelled as categorical variables using the 50th and 75th percentiles of the seminoma group. Tail DNA was significantly associated with non-seminoma compared with seminoma (OR(50th percentile) = 3.31, 95% CI: 1.00, 10.98; OR(75th percentile) = 3.71, 95% CI: 1.04, 13.20; p for trend = 0.039). OTM exhibited similar, albeit statistically non-significant, risk estimates (OR(50th percentile) = 2.27, 95% CI: 0.75, 6.87; OR(75th percentile) = 2.40, 95% CI: 0.75, 7.71; p for trend = 0.12) whereas tail length and CDM showed no association. In conclusion, the results for tail DNA and OTM indicate that net endogenous levels are higher in patients who develop non-seminoma compared with seminoma. This may partly explain the more aggressive biology and younger age-of-onset of this histologic subgroup compared with the relatively less aggressive, later-onset seminoma.
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Affiliation(s)
- M B Cook
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-7234, USA.
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Trends in testicular germ cell cancer incidence in Australia. Cancer Causes Control 2008; 19:1043-9. [PMID: 18478339 DOI: 10.1007/s10552-008-9168-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Accepted: 04/17/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Although increasing incidence of testicular germ cell cancer has been reported in many developed nations, national estimates for Australia, with histological differentiation, are not currently available. METHODS Using data from all state and territory population-based cancer registries in Australia, this paper reports on incidence trends for seminomas and non-seminomas in Australia between 1982 and 2004 using Joinpoint and Age-Period-Cohort models. RESULTS Of the 10,528 testicular germ cell cancers diagnosed during this period, 6086 (58%) were seminomas. Incidence rates have increased (2.6% per year) in Australia since 1982, with the effect stronger among seminomas (3.4% per year) rather than non-seminomas (1.4% per year). There was a strong age effect evident for both subtypes, peaking in the 25-29 year age group for non-seminomas and the 30-34 year age group for seminomas. Non-seminoma rates reflected a significant birth cohort effect, following a U-shaped pattern with the lowest risk among the 1,945 birth cohort. CONCLUSIONS The differential trends observed for Australia for seminomas and non-seminomas are consistent with those reported for the United States, but slightly different to those reported for Europe. The trends may be at least partly due to changes over time in the prevalence of etiologic or protective factors around the time of birth.
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Llanes González L, Luján Galán M, Rodríguez García N, García Tello A, Berenguer Sánchez A. Tendencia en la incidencia del cáncer testicular de células germinales en un área sanitaria española de 300.000 habitantes (1991-2005). Actas Urol Esp 2008; 32:691-5. [DOI: 10.1016/s0210-4806(08)73916-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stang A, Rusner C, Eisinger B, Stegmaier C, Kaatsch P. Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries. ACTA ACUST UNITED AC 2007; 32:306-16. [PMID: 18179558 DOI: 10.1111/j.1365-2605.2007.00850.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Comparisons of incidence estimates of testicular cancer subtypes beyond seminoma and non-seminoma are virtually missing in the epidemiologic literature. We analysed incidence data from population-based German cancer registries to provide subtype-specific incidences of testicular cancer. We pooled data from nine cancer registries from 1998 to 2003. We estimated incidence and mortality time trends of West and East Germany. Incidence and mortality were standardized by the European standard population. The annual percentage incidence change from 1961 through 1989 was 4.9% in East Germany and 3.0% from 1970 through 2004 in Saarland. Incidence increases were the most pronounced among adolescents and young men aged 15-49 years. In 1998-2003, the seminoma incidence rate was 5.1 per 100,000; among non-seminomas, the rates were the highest for malignant teratoma (1.6 per 100,000), followed by embryonal carcinoma (1.2 per 100,000). Testicular lymphomas were rare (0.1 per 100,000). The incidence of testicular cancer among children aged 0-14 years was nearly constant from 1987 through 2004. Majority of these cancers were yolk sac tumours (0.1 per 100,000). In East and West Germany, rates of embryonal carcinoma in the early periods were considerably lower than the rates of malignant teratoma. In the most recent periods, rates of embryonal carcinoma became quite similar to the rates of malignant teratoma. The mortality decline started in West Germany roughly 12 years earlier than in East Germany. The later start of the mortality decline in East Germany may be because of a later introduction of platinum-based chemotherapy compared to West Germany.
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Affiliation(s)
- A Stang
- Clinical Epidemiology Unit, Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany.
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Walschaerts M, Huyghe E, Muller A, Bachaud JM, Bujan L, Thonneau P. Doubling of testicular cancer incidence rate over the last 20 years in southern France. Cancer Causes Control 2007; 19:155-61. [PMID: 18236173 DOI: 10.1007/s10552-007-9081-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Accepted: 10/10/2007] [Indexed: 11/28/2022]
Abstract
In recent decades, testicular cancer incidence has considerably increased in a majority of industrialized countries. In France, short reports suggested that the testicular cancer incidence rate has also risen, especially in north-eastern regions. In Europe, geographical variation of incidence rates has been observed in Baltic countries and a clear birth cohort effect has been revealed. This study aimed to assess temporal trends in testicular cancer incidence in southern France. We examined incidence rates over a 20-year time period in a series of 506 consecutive cases of testicular cancer recorded from 1980 to 1999 in the Midi-Pyrenees region of France. Age, calendar period, and birth cohort effects were examined simultaneously using Poisson regression models. Our analysis found a significant rise in the overall incidence rate of testicular germ cell tumors from 1.27 to 3.04 per 100,000 between 1980-1984 and 1995-1999, an annual increase of 5.70%. These results, the first obtained in a large series in southern Europe, show a twofold increase in incidence rate of testicular cancer in the Midi-Pyrenees region, which is very similar to that observed in all European countries, more or less doubling in the last 20 years. Interestingly, this major jump and the apparent testicular cancer gradient between northern and southern Europe suggest considerable geographical heterogeneity in incidence, but low geographical variation in temporal trends.
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Affiliation(s)
- Marie Walschaerts
- Human Fertility Research Group (EA 3694), University Paul Sabatier-Toulouse III, INSERM, Toulouse Cedex 9, France
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Stang A, Jöckel KH. Etiologic Conclusions from Similar Birth Cohort Effects. Cancer Epidemiol Biomarkers Prev 2006; 15:1752; author reply 1752-3. [PMID: 16985045 DOI: 10.1158/1055-9965.epi-06-0355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bray F, Richiardi L, Ekbom A, Forman D, Pukkala E, Cuninkova M, Møller H. Etiologic Conclusions from Similar Birth Cohort Effects. Cancer Epidemiol Biomarkers Prev 2006. [DOI: 10.1158/1055-9965.epi-06-0626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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