Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.
Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany; Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Eur Urol. 2015 Aug;68(2):283-9. doi: 10.1016/j.eururo.2014.12.031. Epub 2015 Apr 23.
None of the population-based epidemiologic studies to date has had a large enough sample size to show the familial risk of testicular cancer (TC) by age at diagnosis for patients and their relatives or for rare histologic subtypes.
To estimate absolute and relative risks of TC in relatives of TC patients by age at diagnosis in patients and their relatives and histological subtypes.
DESIGN, SETTING, AND PARTICIPANTS: In a joint population-based cohort study, 97 402 first-degree relatives of 21 254 TC patients who were diagnosed between 1955 and 2010 in five European countries were followed for cancer incidence.
Standardized incidence ratios (SIRs) were estimated using histology-, age-, period-, and country-specific incidence rates as references. Lifetime cumulative risks were also calculated.
The lifetime cumulative risk of TC in brothers of a patient with TC was 2.3%, which represents a fourfold increase in risk (SIR 4.1, 95% confidence interval [CI] 3.6-4.6) compared to the general population. TC in a father increased the risk by up to twofold in his son (95% CI 1.7-2.4; lifetime risk 1.2%) and vice versa. When there were two or more TC patients diagnosed in a family, the lifetime TC risk for relatives was 10-11%. Depending on age at diagnosis, twins had a 9-74% lifetime risk of TC. Family history of most of the histologic subtypes of TC increased the risk of concordant and most discordant subtypes. There was a tendency toward concordant age at diagnosis of TC among relatives.
This study provides clinically relevant age-specific cancer risk estimates for relatives of TC patients. Familial TC patients tended to develop TC at an age close to the age at diagnosis of TC among their relatives, which is a novel finding of this study.
This joint European population study showed that sons and brothers of testicular cancer patients are at higher risk of developing this cancer at an age close to the age at diagnosis of their relatives.
迄今为止，尚无基于人群的流行病学研究具有足够大的样本量，无法按患者及其亲属的诊断年龄或罕见组织学亚型显示睾丸癌（TC）的家族风险。
按患者及其亲属的诊断年龄和组织学亚型，估算 TC 患者亲属的 TC 绝对和相对风险。
设计、地点和参与者：在一项联合人群队列研究中，随访了 5 个欧洲国家在 1955 年至 2010 年间诊断的 21254 例 TC 患者的 97402 位一级亲属的癌症发病情况。
使用组织学、年龄、时期和国家特异性发病率作为参考，估算标准化发病比（SIR）。还计算了终生累积风险。
TC 患者的兄弟患 TC 的终生累积风险为 2.3%，与普通人群相比，风险增加了四倍（SIR 4.1，95%置信区间[CI]3.6-4.6）。父亲患有 TC 会使儿子的风险增加一到两倍（95%CI 1.7-2.4；终生风险 1.2%），反之亦然。如果一个家庭中有两个或更多 TC 患者被诊断，那么亲属的终生 TC 风险为 10-11%。根据诊断时的年龄，双胞胎的终生 TC 风险为 9-74%。大多数 TC 组织学亚型的家族史增加了同型和大多数异型的风险。亲属的 TC 诊断年龄有趋于一致的趋势。
本研究为 TC 患者亲属提供了具有临床意义的年龄特异性癌症风险估计值。TC 家族患者倾向于在与亲属的 TC 诊断年龄相近的年龄患上 TC，这是本研究的一个新发现。
这项欧洲联合人群研究表明，TC 患者的儿子和兄弟患这种癌症的风险更高，发病年龄接近其亲属的诊断年龄。
