Doubling of testicular cancer incidence rate over the last 20 years in Southern France

Human Fertility Research Group (EA 3694), University Paul Sabatier-Toulouse III, INSERM, Toulouse Cedex 9, France.
Cancer Causes and Control (Impact Factor: 2.74). 04/2008; 19(2):155-61. DOI: 10.1007/s10552-007-9081-x
Source: PubMed


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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    • "Notre incidence de 1,13 cas par an est proche de celle rapportée par Ouattara [4] à Cotonou, qui en 3 ans rapporte 3 cas, et de Goumbri [5], qui au Burkina Faso sur une période d'étude de 20 ans a recensé 10 cas de cancer du testicule. En France [3], l'incidence est de 4,5 cas par an/100 000 hommes .Ce qui confirme la rareté de ce cancer. "
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    ABSTRACT: Objective To investigate the clinical features and limitations of therapeutic management of testicular cancer in Senegal. Patients and methods This is a retrospective study over 15 years period between January 1997 and January 2012. Twenty-two cases were collected but only 17 had complete data for analysis. Results The average annual incidence was 1.13 cases per year, with a mean age of 27 ± 9.5 years. The most affected age group was between 21 and 40 years. Clinical diagnosis was suspected by the presence of a scrotal swelling in10 cases and by empty scrotum associated with abdominal or pelvic mass in the remaining 7 cases. Orchiectomy was the main treatment option, done either by high inguinal approach in 8 patients or by trans- peritoneal route in other 7 patients. Histologically, a predominance of embryonic non seminomatous germ cell carcinoma was noted in 10 cases including infantile type in one case. Seven cases developed disease progression:3 cases of peritoneal carcinmatosis, 3 other cases of locoregional invasion with retroperitoneal lymphadenopathy and one case of pulmonary metastasis. At a mean follow up of six months, nine patients died, four were lost to follow up while the remaining four cases were still alive. Conclusion Testicular cancer is a rare tumor in Senegal and usually involves young people. Clinical diagnosis is always done at very advanced stage with a very high mortality rate.
    African Journal of Urology 09/2014; 20(3). DOI:10.1016/j.afju.2014.04.003
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    • "Incidence might be as high as 11.5 per 100,000 in white men compared with 1 to 2 per 100,000 in Blacks and Asian men (Purdue, 2005) (Bray et al., 2006). Across Europe and United states there has been a definite increase in the incidence of this malignancy (Bray et al., 2006; Shah et al., 2007; Walschaerts et al., 2008; Stang et al., 2009). Despite this variability 5 year survival in excess of 90% has been reported in Asian population irrespective of their geographical location (Biggs and Schwartz, 2004; Chia et al., 2010; Nguyen and Ellison, 2005).With this perspective of ethnic variation and gradual increase in incidence of testicular cancer, recent data from South East Asia and in particular Pakistan regarding the profile of testicular tumors at presentation and their treatment is limited. "
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    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.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(1):277-80. DOI:10.7314/APJCP.2014.15.1.277 · 2.51 Impact Factor
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    • "In the developed world the incidence of type II TGCT (seminoma and non-seminoma), but not type I or II, has increased significantly over the last century to become the most common malignancy found in men aged between 20 and 40 years of age 5– 7. Such findings have led to speculation that environmental factors impact on the tumorigenesis of this cancer 8. "
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    ABSTRACT: Since the beginning of the 20th century there has been a decline in the reproductive vitality of men within the Western world. The declining sperm quantity and quality has been associated with increased overt disorders of sexual development including hypospadias, undescended testes and type II testicular germ cell tumours (TGCTs). The increase in TGCTs cannot be accounted for by genetic changes in the population. Therefore exposure to environmental toxicants appears to be a major contributor to the aetiology of TGCTs and men with a genetic predisposition are particularly vulnerable. In particular, Type II TGCTs have been identified to arise from a precursor lesion Carcinoma in situ (CIS), identified as a dysfunctional gonocyte; however, the exact triggers for CIS development are currently unknown. Therefore the transition from gonocytes into spermatogonia is key to those studying TGCTs. Recently we have identified seven miRNA molecules (including members of the miR-290 family and miR-136, 463* and 743a) to be significantly changed over this transition period. These miRNA molecules are predicted to have targets within the CXCR4, PTEN, DHH, RAC and PDGF pathways, all of which have important roles in germ cell migration, proliferation and homing to the spermatogonial stem cell niche. Given the plethora of potential targets affected by each miRNA molecule, subtle changes in miRNA expression could have significant consequences e.g. tumourigenesis. The role of non-traditional oncogenes and tumour suppressors such as miRNA in TGCT is highlighted by the fact that the majority of these tumours express wild type p53, a pivotal tumour suppressor usually inactivated in cancer. While treatment of TGCTs is highly successful, the impact of these treatments on fertility means that identification of exact triggers, earlier diagnosis and alternate treatments are essential. This review examines the genetic factors and possible triggers of type II TGCT to highlight target areas for potential new treatments.
    F1000 Research 02/2013; 2:55. DOI:10.12688/f1000research.2-55.v1
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