Department of Urology, Mainz University Medical Center, Mainz, Germany.
Department of Urology, Medical University of Vienna, Vienna, Austria.
Andrology. 2019 Jul;7(4):408-414. doi: 10.1111/andr.12666.
Testicular germ cell tumor (TGCT) is one the most common solid tumors in men between the age of 15 and 35 with an overall incidence rate of 1-1.5 %. Epidemiologic studies have demonstrated different incidence patterns in western civilized countries with overall rising incidence trends.
To analyze differences in regional tumor incidence rates for TGCT and perform a trend analysis for TGCT between 2003 and 2014 in Germany.
TGCT cases in Germany which were diagnosed between 2003 and 2014 were provided by the Robert-Koch-Institute, Berlin. For statistical analysis, cluster and spatial scan tests according to Kulldorff were used for cases with seminoma and non-seminoma. Results are presented in administrative districts and graphically illustrated. We performed a trend-analysis in order to evaluate age-adjusted incidence trends in Germany. Tests were two-sided with a level of significance of α=0.05.
In total we included 35,066 patients. Overall, 22,634 cases had newly diagnosed seminoma and 12,432 were diagnosed as non-seminoma. Maximum incidence of seminoma and non-seminoma was observed for age-group 38-40 years and 26-28 years, respectively. No second peak for the incidences of seminoma and non-seminoma with respect to age were observed. Cluster analysis revealed areas with high and low incidence rates as well as slightly different spatial distribution in Germany between seminoma and nonseminoma. Furthermore, there was no significant increase in age-adjusted incidence rates over the reviewed time period in both cohorts.
In this study differences in reginal tumor incidence rates for seminoma and non-seminoma are reported with both tumor entities revealing distinct clusters. Furthermore, tumor incidence trends for seminoma and nonseminoma between 2003 and 2014 were stable which might indicate the beginning of a plateau phase for TGCT incidence rates in Germany.
In this analysis we were able to identify regions with significantly higher tumor incidence rates for both seminoma and non-seminoma which were specific for these two subtypes. Furthermore, trend analysis revealed a steady incidence rate for testicular cancer in Germany.
睾丸生殖细胞肿瘤（TGCT）是 15-35 岁男性中最常见的实体肿瘤之一，总体发病率为 1-1.5%。流行病学研究表明，在西方文明国家，发病率模式存在差异，总体呈上升趋势。
分析 TGCT 区域性肿瘤发病率的差异，并对德国 2003 年至 2014 年 TGCT 的趋势进行分析。
柏林罗伯特科赫研究所提供了 2003 年至 2014 年期间德国诊断的 TGCT 病例。对于精原细胞瘤和非精原细胞瘤，使用 Kulldorff 聚类和空间扫描检验进行统计分析。结果以行政区表示并以图形方式说明。为了评估德国的年龄调整发病率趋势，我们进行了趋势分析。测试为双侧，显著性水平为α=0.05。
共纳入 35066 例患者。总体而言，22634 例新诊断为精原细胞瘤，12432 例诊断为非精原细胞瘤。精原细胞瘤和非精原细胞瘤的最大发病率分别出现在 38-40 岁和 26-28 岁年龄组。未观察到精原细胞瘤和非精原细胞瘤发病率的第二个高峰。聚类分析显示，德国存在高发病率和低发病率区域以及精原细胞瘤和非精原细胞瘤之间略微不同的空间分布。此外，在两个队列中，在审查期间，年龄调整发病率均无显著增加。
本研究报告了精原细胞瘤和非精原细胞瘤区域性肿瘤发病率的差异，这两种肿瘤均存在明显的聚类。此外，2003 年至 2014 年期间，精原细胞瘤和非精原细胞瘤的肿瘤发病率趋势稳定，这可能表明德国 TGCT 发病率开始进入平台期。
在本分析中，我们能够确定这两种亚型的精原细胞瘤和非精原细胞瘤的肿瘤发病率明显更高的区域。此外，趋势分析显示德国睾丸癌的发病率保持稳定。
