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

Abstract：

: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.

journal_name

Int J Cancer

journal_title

International journal of cancer

authors

Bray F,Richiardi L,Ekbom A,Pukkala E,Cuninkova M,Møller H

doi

10.1002/ijc.21747

keywords:

subject

Has Abstract

pub_date

2006-06-15 00:00:00

pages

3099-111

issue

eissn

0020-7136

issn

1097-0215

journal_volume

118

pub_type

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