Trends in the incidence of testicular germ cell tumors in the United States
Trends in the incidence of testicular germ cell tumors in the United States
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DOI：
10.1002/cncr.11054
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发表时间：
2003-01-01
期刊：
影响因子：
6.2
通讯作者：
Tarone, RE
中科院分区：
文献类型：
--
作者：
McGlynn, KA;Devesa, SS;Tarone, RE
背景资料。最近的报道表明，在一些人群中，睾丸生殖细胞肿瘤的发病率已经开始趋于平台期。这项研究是为了检查美国白人男性的发病率是否已经开始稳定，以及美国黑人男性的发病率是否保持在较低水平。方法：分析1973-1998年间《监测、流行病学和最终结果计划》中的睾丸生殖细胞肿瘤发病率数据。精原细胞瘤和非精原细胞瘤的趋势分别进行了检查。使用5岁年龄间隔和5年日历周期间隔的年龄周期队列分析，检验出生队列趋势的斜率和日历周期效应的变化。结果：在白人男性中，精原细胞瘤的发病率继续上升，但在整个26年的时间跨度中，增长率稳步下降。白人中的非精原细胞瘤发病率在前三个时间间隔内增长较慢，然后在最后一个时间间隔稳定下来。在黑人男性中，精原细胞瘤和非精原细胞瘤的比率在前三个时间间隔内波动。在最后的间歇期，精原细胞瘤的发生率几乎增加了100%，而非精原细胞瘤的比率增加得更温和。白人男性发病率数据的年龄-时期-队列模型发现，虽然主要影响是出生队列的影响，但也有周期效应。结论：在美国白人男性中，睾丸生殖细胞肿瘤的发病率因组织学而异，只有精原细胞瘤的风险持续增加。在美国的黑人男性中，1988年至1998年间的惊人增长很可能是日历时期的影响。
BACKGROUND. Recent reports have suggested that the increasing rates of testicular germ cell tumors in some populations have begun to plateau. This study was conducted to examine whether rates among white men in the United States have begun to stabilize and whether rates among black men in the United States have remained low.METHODS. Testicular germ cell tumor incidence data from in the Surveillance, Epidemiology, and End Results Program were analyzed for the years 1973-1998. Trends were examined separately for seminoma and nonseminoma. Using age-period-cohort analyses with 5-year age intervals and 5-year calendar-period intervals, changes in the slope of the trends in birth-cohort and calendar-period effects were examined.RESULTS. Among white men, rates of seminoma continued to increase, but the rate of increase steadily declined throughout the 26-year time span. Nonseminoma rates among whites increased more slowly during the first three time intervals, then plateaued in the final interval. Rates of both seminoma and nonseminoma in black men fluctuated throughout the first three time intervals. In the final interval, the rates of seminoma increased almost 100%, whereas the rates of nonseminoma increased more modestly. Age-period-cohort modeling of the incidence data in white men found that, whereas the dominant effect was that of birth cohort, there also was a period effect.CONCLUSIONS. Among white men in the United States, the incidence of testicular germ cell tumors varied by histology, with a continuing increase in risk only for seminoma. Among black men in the United States, the surprising increases seen between 1988 and 1998 were likely to be a calendar-period effect.