Trends in testicular cancer incidence and mortality in 22 European countries: Continuing increases in incidence and declines in mortality

被引:234
作者
Bray, Freddie [1 ]
Richiardi, Lorenzo
Ekbom, Anders
Pukkala, Eero
Cuninkova, Martina
Moller, Henrik
机构
[1] Canc Registry Norway, Div Clin & Registry Based Res, N-0310 Oslo, Norway
[2] Int Agcy Res Canc, F-69372 Lyon, France
[3] Univ London London Sch Hyg & Trop Med, London WC1E 7HT, England
[4] Univ Turin, CeRMS, I-10124 Turin, Italy
[5] Univ Turin, Ctr Oncol Prevent, I-10124 Turin, Italy
[6] Karolinska Inst, Stockholm, Sweden
[7] Finnish Canc Registry, FIN-00170 Helsinki, Finland
[8] Slovak Acad Sci, Bratislava, Slovakia
[9] Kings Coll London, Thames Canc Registry, London WC2R 2LS, England
关键词
testicular cancer; incidence; mortality; time trends; epidemiology;
D O I
10.1002/ijc.21747
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
This study profiles testicular cancer incidence and mortality across Europe, and the effects of age, period and generational influences, using age-period-cohort modeling. Despite a 5-fold variation in incidence rates, there were consistent mean increases in incidence in each of the 12 European countries studied, ranging from around 6% per annum (Spain and Slovenia) to 1-2% (Norway). In contrast, declines in testicular cancer mortality of 3-6% per annum were observed in the 1980s and 1990s for the majority of the 22 countries studied, particularly in Northern and Western Europe. The mortality trends in several European countries were rather stable (Romania and Bulgaria) or increasing (Portugal and Croatia). Short-term attenuations in increasing cohort-specific risk of incidence were indicated among men born between 1940 and 1945 in 7 European countries. In Switzerland, successive generations born from the mid 1960s may have experienced a steadily declining risk of disease occurrence. While the underlying risk factors responsible remain elusive, the temporal and geographical variability in incidence may point to an epidemic in different phases in different countries-the result of country-specific differences in the prevalence of one or several ubiquitous and highly prevalent environmental determinants of the disease. Advances in treatment have led to major declines in mortality in many European countries from the mid 1970s, which has translated to cohorts of men at successively lower risk of death from the disease. Slower progress in the delivery of optimal care is however evident from the mortality trends in several lower-resource countries in Southern and Eastern Europe. The first beneficiaries of therapy in these populations may be those men born-rather than diagnosed-in the era of major breakthrough in testicular cancer care. (c) 2006 Wiley-Liss, Inc.
引用
收藏
页码:3099 / 3111
页数:13
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