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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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Tarapore P, Ouyang B. Perfluoroalkyl Chemicals and Male Reproductive Health: Do PFOA and PFOS Increase Risk for Male Infertility? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073794. [PMID: 33916482 PMCID: PMC8038605 DOI: 10.3390/ijerph18073794] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 01/09/2023]
Abstract
Poly- and perfluoroalkyl substances (PFAS) are manmade synthetic chemicals which have been in existence for over 70 years. Though they are currently being phased out, their persistence in the environment is widespread. There is increasing evidence linking PFAS exposure to health effects, an issue of concern since PFAS such as perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) bioaccumulate in humans, with a half-life of years. Many epidemiological studies suggest that, worldwide, semen quality has decreased over the past several decades. One of the most worrying effects of PFOS and PFOA is their associations with lower testosterone levels, similar to clinical observations in infertile men. This review thus focuses on PFOS/PFOA-associated effects on male reproductive health. The sources of PFAS in drinking water are listed. The current epidemiological studies linking increased exposure to PFAS with lowered testosterone and semen quality, and evidence from rodent studies supporting their function as endocrine disruptors on the reproductive system, exhibiting non-monotonic dose responses, are noted. Finally, their mechanisms of action and possible toxic effects on the Leydig, Sertoli, and germ cells are discussed. Future research efforts must consider utilizing better human model systems for exposure, using more accurate PFAS exposure susceptibility windows, and improvements in statistical modeling of data to account for the endocrine disruptor properties of PFAS.
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Affiliation(s)
- Pheruza Tarapore
- Department of Environmental and Public Health Sciences, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA;
- Center of Environmental Genetics, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA
- Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH 45267, USA
- Correspondence: or ; Tel.: +1-513-558-5148
| | - Bin Ouyang
- Department of Environmental and Public Health Sciences, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA;
- Center of Environmental Genetics, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA
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Zarka M, Tretarre B, Rebillard X, Murez T, Daures JP, Azria D, Serre I, Brel D, Ramay AS, Reis Borges R, Gevorgyan A, Hutin M, Marchal S, Korahanis N, Iborra F, Thuret R. [Cancers of the external genital organs of male in Hérault: Results from the Hérault tumor register (RTH) over a period of 30 years (1987-2016)]. Prog Urol 2021; 31:282-292. [PMID: 33593695 DOI: 10.1016/j.purol.2020.08.054] [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: 05/16/2020] [Revised: 07/25/2020] [Accepted: 08/13/2020] [Indexed: 10/22/2022]
Abstract
AIM The objective of this study is to present the history of cancers of the external genital organs of male in Hérault using data from the Hérault tumor register (RTH) over a period of 30 years. PATIENTS AND METHODS Using the RTH database, we studied the development of testicular germ cell tumors (TGCT) and penile cancer (PC) over 30 years, from 1987 to 2016. We analyzed the incidence and mortality data for these tumors. We compared these results to French, European and global data. RESULTS In 30 years of registration we have recorded 725 cases of TGCT and 175 cases of PC. The age standardized incidence rate (ASR) of TGCT has doubled between 1987 and 2016 (4.2 per 100,000 in 1987 and 9.3 per 100,000 in 2016). It was multiplied by 2.63 in the population of patients aged 30 to 44. There is a decrease of the mortality rate with a ASR of 0.8 deaths per 100,000 in 1987, and 0.4/100 000 in 2016. The PC incidence ASR was stable between 1987 and 2016 (0.4-0.9/100,000). Mortality is stable with a ASR between 0.1 and 0.3 deaths per 100,000 between 1987 and 2016. CONCLUSION The incidence of TGCT has increased sharply in the Hérault over the past 30 years, while a decrease in mortality has been observed. The proportion of seminomas is increasing; it has gone from 53 % to 60 % in 30 years in the Hérault. The incidence and mortality of PC shows a stability in the Hérault over the past 30 years.
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Affiliation(s)
- M Zarka
- Service d'urologie et transplantation rénale, CHU Montpellier Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France.
| | - B Tretarre
- Registre des tumeurs de l'Hérault, Montpellier, France
| | - X Rebillard
- Service d'urologie, clinique beau soleil, Montpellier, France
| | - T Murez
- Service d'urologie et transplantation rénale, CHU Montpellier, Montpellier, France
| | - J P Daures
- Clinique beau soleil, IURC, Montpellier, France
| | - D Azria
- ICM, Univ Montpellier, inserm U 1194, Montpellier, France
| | - I Serre
- Service d'anatomopathologie, CHU Montpellier, Montpellier, France
| | - D Brel
- Service d'anatomopathologie, CH Béziers, Béziers, France
| | - A S Ramay
- Laboratoire de biologie médicale Medipath, Montpellier, France
| | - R Reis Borges
- Laboratoire de biologie médicale Labosud-Ob Biologie, Montpellier, France
| | - A Gevorgyan
- Polyclinique Saint-Privat, Boujan sur Libron, France
| | - M Hutin
- Service d'urologie, clinique beau soleil, Montpellier, France
| | - S Marchal
- Clinique du parc, Castelnau-le-lez, France
| | | | - F Iborra
- Service d'urologie et transplantation rénale, CHU Montpellier, Montpellier, France
| | - R Thuret
- Service d'urologie et transplantation rénale, CHU Montpellier, Montpellier, France
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Pietrzyk Ł, Denisow-Pietrzyk M, Czeczelewski M, Ślizień-Kuczapski K, Torres K. Cancer education matters: a report on testicular cancer knowledge, awareness, and self-examination practice among young Polish men. Sci Rep 2020; 10:20684. [PMID: 33244121 PMCID: PMC7693263 DOI: 10.1038/s41598-020-77734-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022] Open
Abstract
The objective of the study was to assess the level of testicular cancer (TC) knowledge and awareness as well as the altitude and practice towards testicular self-examination (TSE) among Polish male high school and medical students. An original questionnaire survey was conducted in SE Poland with a representative sample of 1077 male students: 335 from high school and 742 medical students. The results indicate the knowledge about TC epidemiology and the awareness of risk factors responsible for the TC was low. The knowledge of the signs and symptoms of TC was significantly higher among the medical students, compared to the high school students. The level of education was associated with the awareness of methods for early detection and symptoms of TC. A satisfactory level of awareness of the TSE practice was exhibited only by the medical students. The main reason for not performing self-examination was the lack of knowledge and practical skills. The deficits of knowledge of TC in young men should motivate the education policy makers in Poland to implement education in the field of TC issues more widely in high schools. Moreover, cancer prevention modules and/or teaching methods should be improved in medical schools.
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Affiliation(s)
- Łukasz Pietrzyk
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland. .,Department of General, Oncological, and Minimally Invasive Surgery, 1st Military Clinical Hospital With the Outpatient Clinic in Lublin, Lublin, Poland.
| | - Marta Denisow-Pietrzyk
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Marcin Czeczelewski
- Students' Scientific Association of Medical Simulation, Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Konrad Ślizień-Kuczapski
- Students' Scientific Association of Medical Simulation, Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Kamil Torres
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
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FitzGerald RE. Perspective on Health Effects of Endocrine Disruptors with a Focus on Data Gaps. Chem Res Toxicol 2020; 33:1284-1291. [DOI: 10.1021/acs.chemrestox.9b00529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rex E. FitzGerald
- Swiss Centre for Applied Human Toxicology SCAHT, University of Basel, Missionsstrasse 64, CH-4055 Basel, Switzerland
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Yamashita S, Koyama J, Goto T, Fujii S, Yamada S, Kawasaki Y, Kawamorita N, Mitsuzuka K, Arai Y, Ito A. Trends in Age and Histology of Testicular Cancer from 1980-2019: A Single-Center Study. TOHOKU J EXP MED 2020; 252:219-224. [DOI: 10.1620/tjem.252.219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Juntaro Koyama
- Department of Urology, Tohoku University Graduate School of Medicine
| | - Takuro Goto
- Department of Urology, Tohoku University Graduate School of Medicine
| | - Shinji Fujii
- Department of Urology, Tohoku University Graduate School of Medicine
| | | | | | - Naoki Kawamorita
- Department of Urology, Tohoku University Graduate School of Medicine
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University Graduate School of Medicine
| | - Yoichi Arai
- Department of Urology, Tohoku University Graduate School of Medicine
- Department of Urology, Miyagi Cancer Center
| | - Akihiro Ito
- Department of Urology, Tohoku University Graduate School of Medicine
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