Kolonel L N, Ross R K, Thomas D B, Thompson D J
Natl Cancer Inst Monogr. 1982;62:157-60.
Although a rare tumor, testicular cancer shows substantial international variation in incidence. In whites, the peak incidence occurs at 25-30 years of age, with a second increase in old age. Blacks have much lower rates than do whites. The rate of increase in the incidence and mortality of this cancer has been consistent but low during the past 40 years. Risk factors identified in epidemiology studies of testicular cancer include cryptorchidism (best documented), inguinal hernia, testicular injury, wearing of tight-fitting underclothing, obesity, maternal use of exogenous estrogens during pregnancy, higher social class, and professional occupations. Epidemiological evidence provides two etiologic hypotheses: a relative hormone imbalance, particularly an excess of estrogen, and a failure of normal thermal regulation of the testis. In the Pacific Basin region, notable variation in incidence rates is also seen. High-risk populations include whites, Polynesians (in Hawaii and New Zealand), and Native Alaskans. Low-risk groups include Filipinos (in Hawaii and Manila), Japanese (in Hawaii and Japan), Indians, and Malays. Most of this variation occurs in the younger ages (0-54 yr). Several areas for potentially fruitful research on this cancer in the Pacific region are given.
睾丸癌虽然是一种罕见肿瘤，但在国际上发病率存在显著差异。在白人中，发病率高峰出现在25至30岁，老年时会再次上升。黑人的发病率远低于白人。在过去40年里，这种癌症的发病率和死亡率一直呈稳定但较低的增长态势。睾丸癌流行病学研究中确定的风险因素包括隐睾症（记录最详尽）、腹股沟疝、睾丸损伤、穿着紧身内衣、肥胖、母亲在孕期使用外源性雌激素、较高的社会阶层以及职业因素。流行病学证据提出了两种病因假说：相对激素失衡，尤其是雌激素过量，以及睾丸正常体温调节功能障碍。在太平洋盆地地区，发病率也存在显著差异。高危人群包括白人、波利尼西亚人（在夏威夷和新西兰）以及阿拉斯加原住民。低危群体包括菲律宾人（在夏威夷和马尼拉）、日本人（在夏威夷和日本）、印度人以及马来人。这种差异大多出现在较年轻年龄段（0至54岁）。文中给出了太平洋地区关于这种癌症潜在富有成果的几个研究领域。
