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
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.
Available from: Michael J Rovito
- "Considering this widening gap in gender health outcomes , irregular care, and the unique risk posed by TCa, it is important to revise current guidelines for young adult male health care treatment and prevention services. Most literature suggests a knowledge gap within young adult and adolescent males on what the disease is, who is most at-risk, and prevention/treatment options (Rosella, 1994; Trumbo, 2004; Walschaerts et al., 2008; Wanzer, Foster, Servoss, & LaBelle, 2014). Most interventions modestly affect some of the aforementioned variables but few, if any at all, report on long-term successes in making males more efficacious as it pertains to becoming aware of the disease and/or preventing late-stage diagnosis of TCa (see Rovito et al., 2014). "
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ABSTRACT: The phrase "standard of care" is primarily a legal term representing what procedure a reasonable person (i.e., health practitioner) would administer to patients across similar circumstances. One major concern for health practitioners is delivering and advocating for treatments not defined as a standard of care. While providing such treatments may meet certain ethical imperatives, doing so may unwittingly trigger medical malpractice litigation fears from practitioners. Apprehension to deviate, even slightly, from the standard of care may (seem to) put the practitioner at significant risk for litigation, which, in turn, may limit options for treatment and preventive measures recommended by the practitioner. Specific to testicular treatment, certain guidelines exist for cancer, torsion, vasectomy, and scrotal masses, among others. As it relates to screening, practitioner examination is expected for patients presenting with testicular abnormalities. Testicular self-examination (TSE) advocacy, however, is discouraged by the U.S. Preventive Services Task Force, which may prompt a general unwillingness among health practitioners to promote the behavior. Considering the benefits TSE has beyond cancer detection, and the historical support it has received among health practitioners, it is paramount to consider the ethical implications of its official "exclusion" from preventive health and clinical care recommendations (i.e., standard of care). Since good ethics should lead practitioner patient care guidelines, not fear of increased malpractice risks, we recommend the development of a standard of care for counseling males to perform TSE.
Available from: Boubacar Fall
- "Notre incidence de 1,13 cas par an est proche de celle rapportée par Ouattara  à Cotonou, qui en 3 ans rapporte 3 cas, et de Goumbri , qui au Burkina Faso sur une période d'étude de 20 ans a recensé 10 cas de cancer du testicule. En France , l'incidence est de 4,5 cas par an/100 000 hommes .Ce qui confirme la rareté de ce cancer. "
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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.
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.
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.
Available from: Abu Bakar Hafeez Bhatti
- "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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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.
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).
Despite a distinct clinical profile of testicular tumors in Pakistani population, survival is comparable with published reports.
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