The aim of our study was to interpret the changing incidence, and to describe the mortality of patients with testicular cancer in the south of the Netherlands between 1970 and 2004. On the basis of data from the Eindhoven Cancer Registry and Statistics Netherlands, 5-year moving average standardised incidence and mortality rates were calculated. An age-period-cohort (APC) Poisson regression analysis was performed to disentangle time and birth cohort effects on incidence. The incidence rate remained stable for all ages at about 3 per 100,000 person-years until 1989 but increased annually thereafter by 4% to 6 in 2004. This increase can almost completely be attributed to an increase in localised tumours. The largest increase was found for seminoma testicular cancer (TC) patients aged 35-39 and non-seminoma TC patients aged 20-24 years. Relatively more localised and tumours with lymph node metastases were detected in the later periods. APC analysis showed the best fit with an age-cohort model. An increase in incidence of TC was found for birth cohorts since 1950. The mortality rate dropped from 1.0 per 100,000 person-years in 1970 to 0.3 in 2005, with a steep annual decline of 12% in the period 1979-1986. In conclusion, the increase in incidence of TC was strongly correlated with birth cohorts since 1945. The increase in incidence is possibly caused by in utero or early life exposure to a yet unknown risk factor. There was a steep decline in mortality in the period 1979-1986.

译文

:我们研究的目的是解释变化的发生率,并描述1970年至2004年之间荷兰南部睾丸癌患者的死亡率。根据荷兰埃因霍温癌症登记与统计局提供的数据,5-计算了年度移动平均标准化发病率和死亡率。进行年龄-年龄组(APC)Poisson回归分析,以弄清时间和出生队列对发病率的影响。到1989年,所有年龄段的发病率一直保持稳定,大约为每100,000人年3例,但此后每年以4%的速度增加,到2004年增加到6个。这种增加几乎可以完全归因于局部肿瘤的增加。发现增加最大的是年龄在35-39岁的精原细胞睾丸癌(TC)患者和年龄在20-24岁的非精原细胞TC患者。相对较局限的是在后期发现有淋巴结转移的肿瘤。 APC分析显示最适合年龄组模型。自1950年以来,出生队列的TC发病率有所增加。死亡率从1970年的每100,000人年1.0下降到2005年的0.3,在1979-1986年期间每年急剧下降12%。总之,自1945年以来,TC发病率的增加与出生队列密切相关。发病率的增加可能是由于子宫内或生命早期暴露于未知的危险因素引起的。 1979-1986年期间死亡率急剧下降。

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