dos Santos Silva I, Swerdlow A J, Stiller C A, Reid A
Cancer and Public Health Unit, London School of Hygiene and Tropical Medicine, London, UK. isabel.silva/@1shtm.ac.uk
Int J Cancer. 1999 Nov 26;83(5):630-4. doi: 10.1002/(sici)1097-0215(19991126)83:5<630::aid-ijc11>3.0.co;2-m.
The incidence of testicular cancer has been increasing markedly in most industrialised countries. This rise is known to have affected young adults, but it is less clear whether it has affected other age groups, particularly children. We used data from the National Cancer Registry file at the Office of National Statistics (ONS) and the National Registry of Childhood Tumours to examine trends in testicular germ-cell malignancies overall in England and Wales from 1962 to 1990 and in children from 1962 to 1995. The incidence of testicular cancer at all ages rose by 3.4% (95% CI 3.3-3.6%) per annum from 1962 to 1990. A similar rise in the incidence of germ-cell malignancies occurred during the years for which histological information was available in the ONS files, 1971-1989 (3.4%; 3.1-3.6%), to which both seminomas and non-seminomas contributed equally. The incidence of non-seminomas in adults rose in men under age 55 years and declined in older men, whereas there were increases in the incidence of seminomas in both young and older men. Cohort analysis at young ages showed a marked rise in the risk of germ-cell malignancies up to the cohort born in 1955-1959 but no further rise for those born subsequently. The rise in the incidence of these tumours in young adults was paralleled by a similar trend, although less marked, in children aged under 15 years (1.3% per annum; 0.2-2.5%). The increase in risk for children in this very large data set alongside the rise in young adults is compatible with the hypothesis that childhood and adult testicular germ-cell malignancies may have some common risk factors, presumably pre-natal.
在大多数工业化国家，睾丸癌的发病率一直在显著上升。已知这种上升趋势影响了年轻人，但对于它是否影响了其他年龄组，尤其是儿童，目前尚不清楚。我们使用了国家统计局（ONS）的国家癌症登记档案数据以及国家儿童肿瘤登记处的数据，来研究1962年至1990年英格兰和威尔士睾丸生殖细胞恶性肿瘤的总体趋势，以及1962年至1995年儿童的相关趋势。从1962年到1990年，所有年龄段的睾丸癌发病率每年上升3.4%（95%可信区间3.3 - 3.6%）。在ONS档案中有组织学信息的年份，即1971 - 1989年，生殖细胞恶性肿瘤的发病率也有类似上升（3.4%；3.1 - 3.6%），精原细胞瘤和非精原细胞瘤的贡献相当。成人中非精原细胞瘤的发病率在55岁以下男性中上升，在老年男性中下降，而精原细胞瘤在年轻男性和老年男性中的发病率均有所上升。对年轻人群的队列分析显示，直到1955 - 1959年出生的队列，生殖细胞恶性肿瘤的风险显著上升，但随后出生的队列则没有进一步上升。年轻人中这些肿瘤发病率的上升，在15岁以下儿童中也有类似趋势，尽管不太明显（每年1.3%；0.2 - 2.5%）。在这个非常大的数据集中，儿童风险的增加与年轻人发病率的上升相一致，这与儿童和成人睾丸生殖细胞恶性肿瘤可能有一些共同风险因素（大概是产前因素） 的假设相符。
