Institute of Clinical Epidemiology, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle, Germany.
Cancer Epidemiol. 2010 Feb;34(1):13-9. doi: 10.1016/j.canep.2009.11.007. Epub 2010 Feb 8.
Currently, only 7 out of 16 Federal States of Germany provide testicular cancer incidence rates with an estimated completeness of at least 90% which complicates the regional comparison of incidence rates. The aim of this study was to provide a novel approach to estimate the testicular cancer incidence in Germany by using nationwide hospitalization data.
We used the nationwide hospitalization data (DRG statistics) of the years 2005-2006 including 16,6 million hospitalizations among men. We identified incident testicular cancer cases by the combination of a diagnosis of testicular cancer and an orchiectomy during the same hospitalization and estimated the age-specific and age-standardized (World Standard Population) incidence of testicular cancer across Federal States. We also analyzed available cancer registry data from 2005 to 2006.
A total of 8544 hospitalizations indicated incident testicular cancer cases in 2005-2006. The nationwide crude incidence rate of testicular cancer was 10,6 per 100.000 person-years. The ratio of the number of registered cases (cancer registry) to the estimated number of cases based on the hospitalization statistics ranged between 79% and 100%. There was only little variation of the age-standardized DRG-based incidence estimates across Federal States (range: 8,2-10,6 per 100.000 person-years).
We provided testicular cancer incidence estimates for each of the 16 Federal States of Germany based on hospitalization data for the first time. The low within-population incidence variability in Germany and high between-population incidence variability in Europe may indicate that ecologic factors play a causal role in the European variation of testicular cancer.
目前，德国仅有 16 个联邦州中的 7 个提供了估计完整性至少为 90%的睾丸癌发病率数据，这使得发病率的区域比较变得复杂。本研究的目的是利用全国性住院数据为德国提供一种估算睾丸癌发病率的新方法。
我们使用了 2005-2006 年包括 1660 万男性住院的全国性住院数据（DRG 统计数据）。我们通过将睾丸癌诊断与同一住院期间的睾丸切除术相结合，确定了睾丸癌的发病病例，并估算了各联邦州的年龄特异性和年龄标准化（世界标准人口）睾丸癌发病率。我们还分析了 2005 年至 2006 年的现有癌症登记数据。
2005-2006 年共有 8544 例住院病例表明存在睾丸癌发病。睾丸癌的全国粗发病率为 10.6/10 万人口年。登记病例数（癌症登记处）与基于住院统计数据估计的病例数之比在 79%至 100%之间。各联邦州之间年龄标准化基于 DRG 的发病率估计值差异很小（范围：8.2-10.6/10 万人口年）。
我们首次根据住院数据为德国的每个联邦州提供了睾丸癌发病率估计值。德国人群内发病率的低变异性和欧洲人群间发病率的高变异性可能表明，生态因素在欧洲睾丸癌的变异中起因果作用。
