Cayuela L, Cabrera Fernández S, Pereyra-Rodríguez J J, Hernández-Rodríguez J C, Cayuela A
Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Spain.
061 Centro de Emergencias Sanitarias, Servicio Andaluz de Salud, Sevilla, Andalucía, Spain.
Actas Urol Esp (Engl Ed). 2024 Oct;48(8):596-602. doi: 10.1016/j.acuroe.2024.05.003. Epub 2024 May 9.
Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.
We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.
A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.
While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.
睾丸癌主要影响年轻男性，在全球范围内呈惊人的上升趋势。本研究利用全球疾病负担（GBD）数据库和年龄-时期-队列（A-P-C）模型，深入探讨了1990年至2019年西班牙的发病率和死亡率趋势。
我们分析了西班牙睾丸癌病例和死亡的GBD数据，计算年龄标准化率（ASIR和ASMR），并采用Joinpoint回归来确定显著变化。A-P-C模型进一步剖析了年龄、时期和出生队列对这些趋势的影响。
观察到睾丸癌发病率显著翻倍，从每10万名男性3.09例增至5.40例（年增长率1.9%），而死亡率保持稳定，甚至在较年轻年龄组有所下降（从每10万例0.34例降至0.26例，年下降率0.8%）。Joinpoint分析揭示了发病率上升的四个不同时期，近期有所放缓。A-P-C模型强调，1935年后出生的每一代，发病风险持续上升，与之形成对比的是，各队列的死亡风险逐渐下降，自20世纪60年代以来出生的人群尤为明显。
虽然死亡率令人鼓舞，但西班牙反映了全球睾丸癌发病率不断上升的趋势。A-P-C分析表明存在代际影响，但其根本原因仍不明确。进一步的研究对于理解这些趋势并实施有效的预防策略以应对这一日益严重的健康问题至关重要。
