Rates Of Testicular Cancer Research Articles

Effects of Chemotherapy on Aneuploidy Rates in Sperm from Male Patients with Testicular Cancer or Hodgkin's Lymphoma-A Systematic Review.

Testicular cancer and Hodgkin's lymphoma are prevalent malignancies among young males aged 20 to 39. The incidence of testicular cancer and lymphoma has risen in recent years, with orchiectomy often followed by adjuvant chemotherapy as the primary treatment for testicular cancer and chemotherapy for lymphoma. Chemotherapy has been associated with an increased risk of aneuploidy and reduced fertility. This systematic review included seven studies, both case-control and longitudinal prospective designs, from the PubMed, Embase, and Cochrane Library databases. The screening process was conducted using the online tool covidence.org. The study outcomes indicate varied impacts of chemotherapy on aneuploidy rates. An increase in the aneuploidy rates, notably for the sex chromosomes, immediately post-treatment was a common trend, followed by a decline in pretreatment values. This systematic review presents the effects of chemotherapy on the aneuploidy rates of testicular cancer and Hodgkin's lymphoma patients, with a decrease post-treatment. The findings underscore the need for larger, well-designed studies with a longer study period.

Malignant ovarian and testicular germ cell tumors: Common characteristics but different prognoses.

Both ovarian and testicular germ cell tumors (GCTs) arise from the primordial germ cell and share many similarities. Both malignancies affect mainly young patients, show remarkable responsiveness to cisplatin-based therapy, and have an excellent prognosis, which also highlights the importance of minimizing long-term side effects. However, certain differences can be noted: The spreading of the disease differs, and the staging system and treatment recommendations are dissimilar. Moreover, the prognosis for ovarian GCTs is significantly inferior to that for testicular cancer, as exemplified in this review comparing the survival in Swedish patients diagnosed with testicular (1995-2022) and ovarian (1990-2018) GCTs. The 5-year overall survival in ovarian GCTs was 85.2%, versus 98.2% for testicular GCTs. How can this be explained? One reason may be the difference in knowledge, experience, and evidence because the incidence rate of testicular cancer is more than 15 times that of ovarian GCTs. Given the rarity of the disease in women and the lack of established guidelines, a comprehensive understanding of the disease and treatment decisions is challenging. The main objective of this review is to derive insights from testicular GCTs (seminoma and non-seminoma) by reviewing etiological, tumor biological, and clinical knowledge, and to thereafter suggest actions for ovarian GCTs based on this. We hypothesize that by adopting specific treatment strategies from testicular GCTs-including de-escalating adjuvant chemotherapy for low-risk patients and implementing more standardized and intensive treatment protocols in cases of relapse-we can improve the prognosis and minimize long-term side effects in ovarian GCT patients.

The burden of testicular cancer from 1990 to 2019 in the Middle East and North Africa region.

The incidence rate of testicular cancer has risen in many countries during recent decades. This study aimed to outline the impact of testicular cancer on the Middle East and North Africa (MENA) region from 1990 to 2019, examining its burden by age group and according to the socio-demographic index (SDI). Data on the incidence, death, and disability-adjusted life-years (DALYs) due to testicular cancer were retrieved from the Global Burden of Disease study 2019. The counts and age-standardized rates (per 100,000) were reported, and all rates were accompanied by 95% uncertainty intervals (UIs). In MENA, the age-standardized incidence rate of testicular cancer was 1.4 per 100,000 in 2019, showing a 244.0% increase since 1990. Similarly, the annual death rate, at 0.1, experienced a 2.6% rise during the same period. In 2019, testicular cancer accounted for 31.1 thousand DALYs, marking an age-standardized rate of 5.0, which was 2.8% higher than in 1990. The 1-4 age group exhibited the largest incidence rate in 2019. In addition, in both 1990 and 2019 the MENA/Global DALY ratio was higher than one in the 1-14 year age groups. During the period 1990 to 2019, the age-standardized DALY rate of testicular cancer steadily rose with higher SDI values, except for a decrease observed at an SDI of 0.8. Over the last thirty years, there has been a notable rise in the burden of testicular cancer in the MENA region.

No evidence for seasonal variations of the incidence of testicular germ cell tumours in Germany.

The pathogenesis of testicular germ cell tumours (GCTs) is still incompletely understood. Any progress in its understanding must derive from observational studies. Recently, it has been suggested that the incidence of GCTs may follow a seasonal pattern based on circannual changes in the Vitamin D serum levels, with maximum incidence rates in winter months. To examine this promising hypothesis, we studied monthly incidence rates of testicular GCTs in Germany by analysing 30,988 GCT cases aged 15-69 years, diagnosed during 2009-2019. Monthly incident case numbers with data regarding histology and patient age were obtained from the Robert Koch Institut, Berlin, along with annual male population counts. We used precision weighting for deriving pooled monthly incidence rates for GCTs of the period 2009-2019. We stratified pooled rates by histology (seminoma and nonseminoma) and age (15-39 and 40-69 years). By assuming a cyclical effect, we used an estimator of the intensity of seasonal occurrence and report seasonal relative risks (RR). The mean monthly incidence rate was 11.93/105 person-months. The seasonal RR for testicular cancer over-all is 1.022 (95% CI 1.000-1.054). The highest seasonal RR was found in the subgroup of nonseminoma aged 15-39 years, with a RR 1.044 (95% CI 1.000-1.112). The comparison of the pooled monthly rates of the winter months (October-March) with the summer months (April-September) revealed a maximum relative difference of 5% (95% CI 1-10%) for nonseminoma, aged 15-39 years. We conclude that there is no evidence of a seasonal variation of incidence rates of testicular cancer. Our results are at odds with an Austrian study, but the present data appear sound because the results were obtained with precision weighted monthly incidence rates in a large population of GCT cases.

State Trends of Cannabis Liberalization as a Causal Driver of Increasing Testicular Cancer Rates across the USA.

Background. The cause of the worldwide doubling-tripling of testicular cancer rates (TCRs) in recent decades is unknown. Previous cohort studies associated cannabis use with TCR including dose–response relationships but the contribution of cannabis to TCRs at the population level is unknown. This relationship was tested by analyzing annual trends across US states and formally assessed causality. Four US datasets were linked at state level: age-adjusted TCRs from Centers for Disease Control Surveillance Epidemiology and End Results database; drug use data from annual National Survey of Drug Use and Health including 74.1% response rate; ethnicity and median household income data from the US Census Bureau; and cannabinoid concentration data from Drug Enforcement Agency reports. Data was processed in R in spatiotemporal and causal inference protocols. Results. Cannabis-use quintile scatterplot-time and boxplots closely paralleled those for TCRs. The highest cannabis-use quintile had a higher TCR than others (3.44 ± 0.05 vs. 2.91 ± 0.2, mean ± S.E.M., t = 10.68, p = 1.29 × 10−22). A dose–response relationship was seen between TCR and Δ9-tetrahydrocannabinol (THC), cannabinol, cannabigerol, and cannabichromene (6.75 × 10−9 < p < 1.83 × 10−142). In a multivariate inverse probability-weighted interactive regression including race and ethnic cannabis exposure (ECE), ECE was significantly related to TCR (β-estimate = 0.89 (95%C.I. 0.36, 2.67), p < 2.2 × 10−16). In an additive geospatiotemporal model controlling for other drugs, cannabis alone was significant (β-estimate = 0.19 (0.10, 0.28), p = 3.4 × 10−5). In a full geospatial model including drugs, income and ethnicity cannabinoid exposure was significant (cannabigerol: β-estimate = 1.39 (0.024, 2.53), p = 0.0017); a pattern repeated at two spatial and two temporal lags (cannabigerol: β-estimate = 0.71 (0.05, 1.37), p = 0.0.0350; THC: β-estimate = 23.60 (11.92, 35.29), p = 7.5 × 10–5). 40/41 e-Values > 1.25 ranged up to 1.4 × 1063 and 10 > 1000 fitting causal relationship criteria. Cannabis liberalization was associated with higher TCRs (ChiSqu. = 312.2, p = 2.64 × 10−11). Rates of TC in cannabis-legal states were elevated (3.36 ± 0.09 vs. 3.01 ± 0.03, t = 4.69, p = 4.86 × 10−5). Conclusions. Cannabis use is closely and causally associated with TCRs across both time and space and higher in States with liberal cannabis legislation. Strong dose–response effects were demonstrated for THC, cannabigerol, cannabinol, cannabichromene and cannabidiol. Cannabinoid genotoxicity replicates all major steps to testicular carcinogenesis including whole-genome doubling, chromosomal arm excision, generalized DNA demethylation and chromosomal translocations thereby accelerating the pathway to testicular carcinogenesis by several decades.

Testicular germ cell cancer in Africa: A survey on patterns of practice

Background: Testicular germ cell tumours (GCTs) are rare malignancies most prevalent in 15–40-year-old men. Incidence rates of testicular cancer on a global level show marked geographic variation with higher incidence rates reported in predominantly Caucasian populations. African data on GCT management show low incidence rates but an advanced stage at presentation and high mortality rates.Aim: The aim of the study was to explore patterns of practice in the management of testicual GCTs.Setting: The study was conducted in an African oncology care setting.Methods: A cross-sectional web-based survey was distributed to doctors or nurses providing oncology care for patients with testicular GCT in Africa. Data on staging procedures, chemotherapy and radiotherapy (RT) treatment schedules across institutions are reported and discussed in the context of international treatment guidelines and local resources.Results: Eleven African countries contributed data. Epidemiological estimates were received from 20 institutions and management and outcome data from 18 institutions. The estimated ratio of seminoma to non-seminoma was 1:1.3. The stage at presentation was tumour-node-metastases-serum marker (TNM-S) Stage III at half of the institutions surveyed. Chemotherapy regimens mostly followed international guidelines, but certain essential drugs were not consistently accessible at all centres. Radiotherapy services were available to all but one respondent, with three-dimensional planning being widely used. There was marked variation in RT doses and treatment fields.Conclusion: The resources to effectively manage testicular GCT appear to be accessible to most institutions surveyed. Regional management guidelines, sharing of clinical expertise within Africa through online platforms and centralised data collection on epidemiology, management and treatment efficacy are advocated to better allocate resources and improve the outcomes reported in this rare but potentially curable condition.

The systematic analysis and 10-year prediction on disease burden of childhood cancer in China.

BackgroundThere is a lack of in-depth analysis regarding the disease burden of childhood cancer in China. Indeed, this is the first time the topic has been addressed in detail. Drawing on population-based data for the past 30 years, this study systematically analyzes the composition and long-term trend of this disease burden in China.MethodsGBD 2019 contained population-based data from 1990 to 2019 and was prepared using Microsoft Excel 2016. We used AAPC and ARIMA models for trend analysis and prediction formulation.ResultsIn 2019, there were 45,601 new cases, 9,156 cancer deaths, and 782,530 DALYs in China. From 1990 to 2019, leukemia, together with brain and CNS cancer, invariably ranked highest in terms of new cases, cancer deaths, and DALYs. Leukemia accounted for more than 50%, but decreased over time. By contrast, the proportions for brain and CNS cancer increased. There were significant decreases in the overall incidence, mortality, and DALY rates in China, but these were still higher than the corresponding global average levels. Considering all types of childhood cancer, the incidence rate of testicular cancer showed the biggest increase, and the mortality and DALY rates of leukemia showed the largest decrease. In terms of different age groups, the overall incidence rate of childhood cancers increased in 0 to 4 age group, but it decreased in 5 to 14 age groups. The overall mortality and DALY rates of childhood cancers decreased in all four age groups. Over the next 10 years, the overall incidence rate of childhood cancer will increase, but the overall mortality and DALY rates will decrease. The increase in malignant skin melanoma will comprise the largest rise in the incidence, while the decrease for leukemia will be the largest fall in the incidence, cancer deaths, and DALYs.ConclusionThe disease burden of all childhood cancers in China remains highly serious, especially for certain types of cancer and certain age groups. China should focus more emphatically on the incidence of childhood cancer in future, and it must consistently strengthen investment in the relevant research and medical resources to reduce the disease burden in this field.

Eicosanoid Biosynthesis in Male Reproductive Development: Effects of Perinatal Exposure to NSAIDs and Analgesic Drugs.

Increasing rates of infertility associated with declining sperm counts and quality, as well as increasing rates of testicular cancer are contemporary issues in the United States and abroad. These conditions are part of the Testicular Dysgenesis Syndrome, which includes a variety of male reproductive disorders hypothesized to share a common origin based on disrupted testicular development during fetal and neonatal stages of life. Male reproductive development is a highly regulated and complex process that relies on an intricate coordination between germ, Leydig, and Sertoli cells as well as other supporting cell types, to ensure proper spermatogenesis, testicular immune privilege, and endocrine function. The eicosanoid system has been reported to be involved in the regulation of fetal and neonatal germ cell development as well as overall testicular homeostasis. Moreover, non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics with abilities to block eicosanoid synthesis by targeting either or both isoforms of cyclooxygenase enzymes, have been found to adversely affect male reproductive development. This review will explore the current body of knowledge on the involvement of the eicosanoid system in male reproductive development, as well as discuss adverse effects of NSAIDs and analgesic drugs administered perinatally, focusing on toxicities reported in the testis and on major testicular cell types. Rodent and epidemiological studies will be corroborated by findings in invertebrate models for a comprehensive report of the state of the field, and to add to our understanding of the potential long-term effects of NSAID and analgesic drug administration in infants.

Racial, ethnic, and geographical differences in testicular cancer mortality trends in the United States.

409 Background: Incidence rates of Testicular cancer (TC) have been slowly increasing in the United States in recent decades. Prior research has identified racial disparities in mortality; however, these trends have not been extensively evaluated. Given that TC has a diverse presentation, this study was undertaken to establish racial, ethnic, geographical differences in longitudinal mortality trends. Methods: Age-adjusted cancer mortality rates for TC were obtained for men in the United States from the CDC Wide-ranging Online Data for Epidemiologic Research database. Testicular cancer-specific mortality (TCSM) rates from 1999-2019 were calculated using linear regression. Trends in mortality by race (White versus Black), ethnicity (Hispanic versus non-Hispanic), urbanization, and census region were analyzed using SAS 9.4. TCSM rates were compared by F-test. A two-sided hypothesis test was performed for p-values, where values &lt; 0.05 were considered statistically significant. Results: From 1999-2019, overall age-adjusted TCSM has been slowly, but not significantly, increasing per year (Table). There was worsening TCSM rates for Hispanics (+)0.0019 per 100,000 compared to non-Hispanics (-)0.003; p=0.010. Black men had slightly improved TCSM rates/year (-0.0007) compared to white men (+0.0006); p=0.049. Significant geographical differences in mortality rates were observed, with a decreasing TCSM rate of (-)0.00092 the Northeast and an increasing rate of (+)0.00086 in the West (p = 0.032 for difference between slopes). Among urbanization categories, TCSM rates in Large Central Metros regions (central counties in metro areas with population &gt; 1 million) and Small Metro regions (counties with population 50,000-249,999) were significantly different [(-)0.0004 and (+)0.0022 respectively; p =0.048]. All other comparisons were not significant. Conclusions: Using comprehensive, contemporary data on TCSM over 2 decades, we found significant differences in TCSM rates. Mortality rates from TC have been increasing, particularly among Hispanics. Understanding racial, ethnic, and geographical trends in TCSM rates is important in treating men with the disease and, ultimately, reducing deaths caused by TC.[Table: see text]

Causal inference multiple imputation investigation of the impact of cannabinoids and other substances on ethnic differentials in US testicular cancer incidence

BackgroundEthnic differences in testicular cancer rates (TCRs) are recognized internationally. Cannabis is a known risk factor for testicular cancer (TC) in multiple studies with dose-response effects demonstrated, however the interaction between ancestral and environmental mutagenic effects has not been characterized. We examined the effects of this presumed gene-environment interaction across US states.MethodsState based TCR was downloaded from the Surveillance Epidemiology and End Results (SEER) website via SEERStat. Drug use data for cigarettes, alcohol use disorder, analgesics, cannabis and cocaine was taken from the National Survey of Drug Use and Health a nationally representative study conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) with a 74.1% response rate. Cannabinoid concentrations derived from Drug Enforcement Agency publications. Median household income and ethnicity data (Caucasian-American, African-American, Hispanic-American, Asian-American, American-Indian-Alaska-Native-American, Native-Hawaiian-Pacific-Islander-American) was from the US Census Bureau. Data were processed in R using instrumental regression, causal inference and multiple imputation.Results1975–2017 TCR rose 41% in African-Americans and 78.1% in Caucasian-Americans; 2003–2017 TCR rose 36.1% in Hispanic-Americans and 102.9% in Asian-Pacific-Islander-Americans. Ethnicity-based scatterplot-time and boxplots for cannabis use and TCR closely mirrored each other. At inverse probability-weighted interactive robust regression including drugs, income and ethnicity, ethnic THC exposure was the most significant factor and was independently significant (β-estimate = 4.72 (2.04, 7.41), P = 0.0018). In a similar model THC, and cannabigerol were also significant (both β-estimate = 13.87 (6.33, 21.41), P = 0.0017). In additive instrumental models the interaction of ethnic THC exposure with Asian-American, Hispanic-American, and Native-Hawaiian-Pacific-Islander-American ethnicities was significant (β-estimate = − 0.63 (− 0.74, − 0.52), P = 3.6 × 10− 29, β-estimate = − 0.25 (− 0.32, − 0.18), P = 4.2 × 10− 13, β-estimate = − 0.19 (− 0.25, − 0.13), P = 3.4 × 10− 9). After multiple imputation, ethnic THC exposure became more significant (β-estimate = 0.68 (0.62, 0.74), P = 1.80 × 10− 92). 25/33 e-Values > 1.25 ranging up to 1.07 × 105. Liberalization of cannabis laws was linked with higher TCR’s in Caucasian-Americans (β-estimate = 0.09 (0.06, 0.12), P = 6.5 × 10− 10) and African-Americans (β-estimate = 0.22 (0.12, 0.32), P = 4.4 × 10− 5) and when dichotomized to illegal v. others (t = 6.195, P = 1.18 × 10− 9 and t = 4.50, P = 3.33 × 10− 5).ConclusionCannabis is shown to be a TC risk factor for all ethnicities including Caucasian-American and African-American ancestries, albeit at different rates. For both ancestries cannabis legalization elevated TCR. Dose-response and causal relationships are demonstrated.

Declining sperm counts: The impact of covid-19 on testicular function and sperm parameters and overall male reproductive performance

Male infertility is linked to some viral infections including human papillomavirus (HPV), herpes simplex viruses (HSV) and human immunodeficiency viruses (HIVs). As for acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), its effects on worldwide declines in sperm count and fertility have not been researched thoroughly. With the recent increase of viral infections due to the pandemic, the potential negative impacts that SARS-CoV-2 will have on male reproductive organs and male fertility have raised countless concerns. This review article aims to discuss the possible effects that the SARS-CoV-2 pandemic will have on an already declining male reproductive success while integrating the results of recent studies focusing on similar topics. Furthermore, this article will also mention the future implications that come with a more infertile population. Within the articles studied, it has become apparent that the SARS-CoV-2 pandemic has and will only decrease men’s sperm quality further. These findings became apparent through the study of oxidative stress established through the sperm’s production of reactive oxygen species1 and the COVID-19 virus’ ability to attack human spermatozoa produced in the testes due the expression of the ACE2 gene.2 As for the decline in male fertility prior to the SARS-CoV-2 pandemic, there are many factors to be discussed, some of which include: tobacco consumption, alcoholism, diet, electronics, and higher rates of testicular cancer.3

Temporal Trends in the Incidence of Testicular Cancer in the United States over the Past Four Decades

Testicular cancer is the most commonly diagnosed solid-organ neoplasm among young men, with variable incidence across racial groups. Testicular cancer incidence has increased since the 1970s, most notably among white men. Such trends in testicular cancer remain poorly understood. We investigated age-adjusted incidence rates of testicular cancer from 1975 to 2015 using Surveillance, Epidemiology and End Results data to further understand the nature of the temporal trends and potential drivers of disease. Across this time period, white men had the highest incidence and the largest increase in rate; however, we also note more recent increases in the incidence of testicular cancer across all racial groups being examined. Patient summaryWe analyzed the rate of testicular cancer in the United States between 1975 and 2015. In that time, white patients had the highest rate and increase in rate of testicular cancer, but non-white patients also had increasing rates of disease.

Abstract C053: Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California

Abstract Background: Hispanic men in the U.S. experience the second-highest incidence rate of testicular cancer, behind non-Hispanic (NH) White men. Incidence of testicular cancer is increasing in the U.S., despite reports of a plateau during the 1990’s, and increases are especially steep in the Hispanic population. To date, the literature does not address whether the incidence of testicular cancer or the observed increases in incidence differ according to neighborhood factors. Purpose: We examined incidence rates and changes in incidence over time for testicular cancer histologic subtypes (i.e., seminoma and nonseminoma) according to neighborhood socioeconomic status (nSES) among Hispanic and, for comparison, NH White men, and according to neighborhood ethnic enclave among Hispanic men, using California Cancer Registry Data. Methods: We conducted a population-based study of 12,228 Hispanic and NH White men diagnosed with testicular cancer in California during three pericensal periods 1988-1992, 1998-2002, and 2008-2012. We calculated incidence rates according to nSES and, among Hispanics, according to ethnic enclave. Incidence rate ratios were calculated to compare incidence rates across nSES and ethnic enclave and to examine changes in incidence rates over time. Results: Hispanic men residing in high SES neighborhoods, compared to low SES neighborhoods, had greater incidence of both seminoma and nonseminoma testicular cancer across pericensal periods (2008-2012, high to low nSES, seminoma IRR, 1.67; 95% CI, 1.38-2.02 and nonseminoma IRR, 1.22; 95% CI, 1.00-1.48). Hispanic men residing in low ethnic enclave neighborhoods also had higher incidence of both seminoma and nonseminoma across pericensal periods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced increased incidence of seminoma (IRR, 2008-2012 compared to 1998-2002, 1.39; 95% CI, 1.17-1.65) while those residing in both low and middle SES neighborhood experienced increased incidence of nonseminoma (IRR, 2008-2012 compared to 1998-2002 for low nSES, 1.87; 95% CI, 1.57-2.20 and for middle nSES, 1.48; 95% CI, 1.21-1.79). Conclusions: While Hispanic men residing in neighborhoods with higher SES and lower enclave status have greater incidence of both seminoma and nonseminoma testicular cancer, recent increases in incidence are driven by Hispanic men residing in lower SES neighborhoods, particularly for the nonseminoma histologic subtype. Citation Format: Mindy C DeRouen, Meg McKinley, Sumit A Shah, Hala T Borno, Rhonda Aoki, Daphne Y Lichtensztajn, John T Leppert, James D Brooks, Benjamin Chung, Scarlett L Gomez, Iona Cheng. Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C053.

Racial differences in testicular cancer in the United States: descriptive epidemiology

BackgroundTesticular cancer (TC) is the most common malignancy in young adult men, and in many countries the incidence rates of testicular cancer have been increasing since the middle of the twentieth century. Since disease presentation and tumor progression patterns are often heterogeneous across racial groups, there may be important racial differences in recent TC trends.MethodsIn this study, Surveillance, Epidemiology, and End Results (SEER) data on TC patients diagnosed between 1973 and 2015 were analyzed, including the following racial/ethnic groups: non-Hispanic whites (NHW), Hispanic whites (HW), blacks, and Asians and Pacific Islanders (API). Patient characteristics, age-adjusted incidence rates, and survival were compared across racial groups. A multivariate Cox model was used to analyze the survival data of TC patients, in order to evaluate racial differences across several relevant factors, including marital status, age group, histologic type, treatment, stage, and tumor location.ResultsNHWs had the highest incidence rates, followed by blacks, HWs, and APIs. There were significant survival differences among the racial groups, with NHWs having the highest survival rates and blacks having the lowest.ConclusionAn analysis of SEER data showed that racial differences existed among TC patients in the United States with respect to patient characteristics, incidence, and survival. The results can be useful to stakeholders interested in reducing the burden of TC morbidity and mortality.

MP76-10 TEMPORAL TRENDS IN THE INCIDENCE OF TESTICULAR CANCER IN THE UNITED STATES OVER THE PAST FOUR DECADES

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer III (MP76)1 Apr 2020MP76-10 TEMPORAL TRENDS IN THE INCIDENCE OF TESTICULAR CANCER IN THE UNITED STATES OVER THE PAST FOUR DECADES Stephen W. Reese*, Karl H. Tully Herne, Junaid Nabi, Marco Paciotti, Eugene B. Cone, Stuart R. Lipsitz, and Quoc-Dien Trinh Stephen W. Reese*Stephen W. Reese* More articles by this author , Karl H. Tully HerneKarl H. Tully Herne More articles by this author , Junaid NabiJunaid Nabi More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Eugene B. ConeEugene B. Cone More articles by this author , Stuart R. LipsitzStuart R. Lipsitz More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000962.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular cancer is the most commonly diagnosed solid-organ neoplasm in young men, with differences in incidence across racial groups. Testicular cancer incidence has increased since the 1970s, most notable in white men. However trends in testicular cancer remain unknown since the early 2000s. Thus, we investigated age-adjusted incidence rates of testicular cancer, from 1975 to 2015, using SEER data to further understand temporal trends and drivers of disease. METHODS: We queried the Surveillance, Epidemiology and End Results (SEER) database to examine individuals aged 20-45 diagnosed with testicular cancer between 1975-2015 in the nine original SEER registries. We also performed sub-analyses according to stage at presentation and race. Average annual percentage change (AAPC) and 95% CI were calculated to examine changes over time using SEER*Stat Software. RESULTS: 23,560 men were diagnosed with testicular cancer in our study. Most patients had localized disease (68.5%). We observed a significant increase in localized disease over the last four decades, from 7.2 per 100,000 men in 1975 to 11.9 per 100,000 men in 2015 (AAPC 2.0*, 95% CI 1.5-2.5). White patients demonstrated the highest incidence (Range: 3.8 - 11.3/100,000 men) and the largest increase-in-incidence rates (AAPC 2.1*, 95%CI 1.5-2.7). The lowest incidence was observed in black men (AAPC 1.3*, 95% CI: 0.1-2.4). The incidence in white men has plateaued since 2002 (AAPC -0.3, -1.3-0.8), while incidence rates in black men (AAPC 1.3*, 95%CI 0.1-2.4) and men of other races (AAPC 1.9*, 95%CI 1.1-2.7) have increased at the same rate as before 2002 (Figure 2). [* statistically significant, p < 0.05]. CONCLUSIONS: We observed a significant increase in incidence of testicular cancer over the last four decades. Etiologies for increasing rates of testicular cancer and for racial differences in the incidence of testicular cancer remain unclear, however warrant further investigation. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1155-e1155 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen W. Reese* More articles by this author Karl H. Tully Herne More articles by this author Junaid Nabi More articles by this author Marco Paciotti More articles by this author Eugene B. Cone More articles by this author Stuart R. Lipsitz More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement PDF downloadLoading ...

Comparison of diagnostic and treatment guidelines for undescended testis.

Cryptorchidism or undescended testis is the single most common genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%–2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treatment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to protect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intra-abdominal undescended testis, or who underwent delayed orchiopexy. Patients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general population. Self-examination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

A Population-Based Analysis of Incidence, Mortality, and Survival in Testicular Cancer Patients in Lithuania.

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.

International Trends in the Incidence of Testicular Cancer: Lessons from 35 Years and 41 Countries

BackgroundIncidence 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. ObjectiveWe have presented incidence data from 41 countries and evaluated incidence trends for the 35-yr period from 1978 to 2012. Design, setting, and participantsCancer registry data from Cancer Incidence in Five Continents (CI5) volumes V–XI, CI5plus, and the NORDCAN database were analysed. Outcome measurements and statistical analysisAge-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 limitationsWhile 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. ConclusionsThe 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 summaryWe 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.

The rising incidence of testicular cancer among young men in Canada, data from 1971–2015

BackgroundTesticular cancer is the most common malignancy among young men aged 15–44 in Canada. The goal of this analysis was to examine age-period-cohort effects of testicular cancer incidence between 1971 and 2015. MethodsData were collected from the National Cancer Incidence Reporting System and the Canadian Cancer Registry. Birth cohort models were fit using the National Cancer Institute’s web tool. Incidence annual percent changes were estimated using NCI’s Joinpoint Regression Program. ResultsIncidence of testicular cancer in Canada has increased steadily since 1971. A birth cohort effect was observed for men born in the years after 1945. The rate of testicular cancer peaks at age 35 and drops off with increasing age. ConclusionIncidence of testicular cancer has risen dramatically in Canada in recent decades and the cohort effect indicates the need to investigate exposures that have increased since 1945 and that may affect development in young men.

Effect of Zinc on Spermatogenesis and Sperm Chromatin Condensation in Bleomycin, Etoposide, Cisplatin Treated Rats.

Objective The incidence rate of testicular cancer among young males is high. Co-administration of bleomycin, etoposide and cisplatin (BEP) has increased survival rate of patients with testicular cancer. Although BEP is one of the most effective treatment for testicular cancer, but it severely affects the reproductive system that ultimately leads to infertility. In addition to its antioxidant activity, zinc has an important role in progression of spermiogenesis. This study aimed to evaluate the effect of zinc on sperm parameters, chromatin condensation and testicular structure after BEP treatment. Materials and Methods In this experimental study, 40 male rats were divided into 4 groups (control, BEP, BEP+ zinc and zinc) and examined for 2 spermatogenesis periods (i.e. 18 weeks). The rats in BEP and BEP+ zinc group were treated with BEP at appropriate doses (0.75, 7.5, and 1.5 mg/kg) for three cycles of three weeks. Zinc at a dose of 10 mg/kg/day was administered to BEP+ zinc and zinc groups. After 18 weeks, we assessed sperm parameters, and excessive histone in sperm chromatin using aniline blue staining, as well as testicular structure and germ line cells using periodic acid-Schiff staining. Results After BEP treatment, significant decreases were observed in normal sperm morphology, motility, and concentration, as well as alterations in rat sperm chromatin condensation and testicular tissue (P<0.001). Furthermore, after zinc consumption for 9 weeks, we observed significant improvements of sperm parameters and chromatin condensation as well as a significant retrieval of spermatogonia, leydig cells and tubular architecture (P<0.05). ConclusionZinc administration after chemotherapy with BEP in testicular cancer might be potentially useful in declining the off target consequence associated with oxidative stress.