Testicular Cancers

Epidemiology of Cancers: Testicular Cancers

Description

Testicular cancer occurs in two main histopathologic types, seminomas and nonseminomas - (predominantly teratomas). While these two types have different clinical characteristics, they are infrequently distinguished in epidemiological literature1.

Symptoms
A painless palpable mass usually perceived as an enlargement of the testicle is the cardinal symptom testicular cancer1.

Epidemiology

  • Worldwide the incidence of testicular cancer is relatively low. However, it is the most common cancer reported in men aged 15-44.
  • Significant geographic variation in incidence is observed worldwide, with the highest rates reported among white Caucasian populations, particularly in the United States and in Northern Europe where there is a clear north/south gradient with rates in Denmark being 5 times higher than in Spain. The lowest rates are observed in Eastern European and Asian populations1,2.
  • In the United States the risk of testicular cancer among Caucasian men is 5-10 times that of Afro-Caribbean men.
  • Worldwide the incidence of testicular cancer has been increasing since the 1920s. Annual increases of 2.3% and 6.5% haven been reported for a number of countries in Europe, the United State (among white males), Australia, Japan and New Zealand1.  The greatest increase has been observed in men aged 35-441.   whose rates more than doubled between the late 1970s and the early 2000s1,2.
  • In the UK age standardized (European) rates have more than double since 19792.
  • Approximately 50% of cases of testicular cancer occur in men < 35 years (92% in men < 55 years). The peak incidence rates of 15/100,000 males are found in the 30-39 age group2.
  • In the UK around 2000 newly diagnosed cases and 90 deaths from testicular cancer occur each year.
  • Testicular cancer is one of the most curable forms of cancer. The 5 year relative survival rate for cancer which has not spread is 99%. For cases were the cancer has spread beyond the lymph nodes the 5-year survival rate is around 72%. 

Risk Factors
Established risk factors include:

  • Age
  • Area of residence
  • Family history
  • Ethnic group
  • Cryptorchidism

Screening and Prevention

  • Education and self examination
  • Not a candidate for national screening programme (relatively rare and low mortality)

References

  1. Adami, H.O., D. Hunter, and D. Trichopoulos, eds. Textbook of Cancer Epidemiology. 2002, Oxford University Press: New York.
     
  2. Cancer Research UK
     
  3. Office for National Statistics. Cancer Statistics registrations: Registrations of cancer diagnosed in 2003, England. Series MB1 no.33. 2005. Available online http://www.statistics.gov.uk/downloads/

© CM Kirwan 2006