1. Second malignancies among survivors of germ-cell testicular cancer: A pooled analysis between 13 cancer registries
- Author
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Lorenzo Richiardi, Vera Pompe-Kirn, Paul Brennan, Paolo Boffetta, Kari Hemminki, Jørgen H. Olsen, Eero Pukkala, Erich V. Kliewer, David H. Brewster, Jon Tonita, Chia Kee-Seng, Mary L. McBride, Ghislaine Scelo, Elizabeth Tracey, Elisabete Weiderpass, Jon G. Jonasson, Carmen Martos, Richiardi, L., Scélo, G., Boffetta, P., Hemminki, K., Pukkala, E., Olsen, J.H., Weiderpass, E., Tracey, E., Brewster, D.H., McBride, M.L., Kliewer, E.V., Tonita, J.M., Pompe-Kirn, V., Kee-Seng, C., Jonasson, J.G., Martos, C., and Brennan, P.
- Subjects
Adult ,Male ,Oncology ,Canada ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Testicular Neoplasms ,Risk Factors ,Internal medicine ,medicine ,Humans ,Registries ,Survivors ,Risk factor ,Testicular cancer ,Singapore ,business.industry ,Incidence ,Incidence (epidemiology) ,Australia ,Cancer ,Neoplasms, Second Primary ,Seminoma ,Middle Aged ,Neoplasms, Germ Cell and Embryonal ,medicine.disease ,Surgery ,Europe ,Radiation therapy ,Germ-cell testicular cancer ,Sarcoma ,Skin cancer ,business ,Follow-Up Studies - Abstract
We investigated the risk of second malignancies among 29,511 survivors of germ-cell testicular cancer recorded in 13 cancer registries. Standardized incidence ratios (SIRs) were estimated comparing the observed numbers of second malignancies with the expected numbers obtained from sex-, age-, period- and population-specific incidence rates. Seminomas and nonseminomas, the 2 main histological groups of testicular cancer, were analyzed separately. During a median follow-up period of 8.3 years (0-35 years), we observed 1,811 second tumors, with a corresponding SIR of 1.65 (95% confidence interval (CI): 1.57-1.73). Statistically significant increased risks were found for fifteen cancer types, including SIRs of 2.0 or higher for cancers of the stomach, gallbladder and bile ducts, pancreas, bladder, kidney, thyroid, and for soft-tissue sarcoma, nonmelanoma skin cancer and myeloid leukemia. The SIR for myeloid leukemia was 2.39 (95% CI: 1.41-3.77) after seminomas, and 6.77 (95% CI: 4.14-10.5) after nonseminomas. It increased to 37.9 (95% CI: 18.9-67.8; based on 11 observed cases of leukemia) among nonseminoma patients diagnosed since 1990. SIRs for most solid cancers increased with follow-up duration, whereas they did not change with year of testicular cancer diagnosis. Among subjects diagnosed before 1980, 20 year survivors of seminoma had a cumulative risk of solid cancer of 9.6% (95% CI: 8.7-10.5%) vs. 6.5% expected, whereas 20 years survivors of non-seminoma had a risk of 5.0% (95% CI: 4.2-6.0%) vs. 3.1% expected. In conclusion, survivors of testicular cancers have an increased risk of several second primaries, where the effect of the treatment seems to play a major role. © 2006 Wiley-Liss, Inc.
- Published
- 2007