Adami H O, Bergström R, Möhner M, Zatoński W, Storm H, Ekbom A, Tretli S, Teppo L, Ziegler H, Rahu M
Department of Cancer Epidemiology, Uppsala University, Sweden.
Int J Cancer. 1994 Oct 1;59(1):33-8. doi: 10.1002/ijc.2910590108.
The incidence of testicular cancer was examined in the Nordic and Baltic countries, Poland and Germany by collaboration among 10 cancer registries. Population-based registers were used to analyze a total of 34,309 cases, diagnosed from the start of registration (varying from 1943 in Denmark to 1980 in Latvia and Lithuania) through 1989. An approximately 10-fold geographical variation was found in 1980, with the highest age-standardized incidence rate (7.8 per 10(5); world standard population) in Denmark and the lowest (0.9) in Lithuania. During the entire period of registration, incidence increased rapidly in all countries, by 2.3 to 3.4 per cent annually in the Nordic countries and by about 5 per cent in Poland and Germany; there was some evidence of a slower increase in Denmark and Poland after 1975. The rising trend was more pronounced for ages below 30. The age-specific incidence peaked in all countries at ages 25 to 34, but the geographical variation was considerable. Our data indicate that environmental influences on testicular cancer are strong. Exposure to causal factors mostly takes place early in life, shows substantial geographical variation, and increases over time, so that the age-standardized incidence doubles every 15 to 25 years. New aetiological hypotheses are needed to accommodate these salient features of the descriptive epidemiology, since risk factors considered so far cannot explain the observed pattern.
10个癌症登记机构合作，对北欧、波罗的海国家、波兰和德国的睾丸癌发病率进行了调查。利用基于人群的登记数据，分析了从登记开始（丹麦始于1943年，拉脱维亚和立陶宛始于1980年）至1989年期间确诊的总计34309例病例。1980年发现地理差异约为10倍，丹麦的年龄标准化发病率最高（每10万人中有7.8例；世界标准人口），立陶宛最低（0.9例）。在整个登记期间，所有国家的发病率均迅速上升，北欧国家每年上升2.3%至3.4%，波兰和德国约为5%；有证据表明，1975年后丹麦和波兰的上升速度有所放缓。30岁以下人群的上升趋势更为明显。所有国家的年龄别发病率在25至34岁时达到峰值，但地理差异很大。我们的数据表明，环境对睾丸癌的影响很大。接触致病因素大多发生在生命早期，存在显著的地理差异，且随时间增加，因此年龄标准化发病率每15至25年翻一番。由于目前考虑的风险因素无法解释观察到的模式，需要新的病因假设来适应描述性流行病学的这些显著特征。
