Second malignancies among survivors of germ‐cell testicular cancer: A pooled analysis between 13 cancer registries
Open Access
- 9 November 2006
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 120 (3), 623-631
- https://doi.org/10.1002/ijc.22345
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 nonseminoma 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.Keywords
This publication has 47 references indexed in Scilit:
- A Pooled Analysis of Second Primary Pancreatic CancerAmerican Journal of Epidemiology, 2006
- Genome-wide linkage screen for testicular germ cell tumour susceptibility lociHuman Molecular Genetics, 2006
- International patterns and trends in testis cancer incidenceInternational Journal of Cancer, 2005
- Therapy-related malignancies following treatment of germ cell cancerInternational Journal of Cancer, 1999
- Risk of a second germ cell cancer after treatment of a primary germ cell cancer in 2201 norwegian male patientsEuropean Journal Of Cancer, 1997
- Risk of subsequent non-germ cell cancer after treatment of germ cell cancer in 2006 Norwegian male patientsEuropean Journal Of Cancer, 1997
- Risk of Secondary Leukemia Following High Cumulative Doses of Etoposide During Chemotherapy for Testicular CancerJNCI Journal of the National Cancer Institute, 1995
- Incidence of second primary cancer following testicular cancerEuropean Journal Of Cancer, 1993
- Secondary Leukemia Associated With a Conventional Dose of Etoposide: Review of Serial Germ Cell Tumor ProtocolsJNCI Journal of the National Cancer Institute, 1993
- Treatment of Disseminated Germ-Cell Tumors with Cisplatin, Bleomycin, and either Vinblastine or EtoposideNew England Journal of Medicine, 1987