Epidemiology of testicular cancer in the Utah population

描述（由申请人提供）：摘要犹他州的睾丸癌发病率是美国所有癌症登记中最高的（2007年为8.3/100，000）。在全球范围内，每年约有52，549例和9，906例死亡是由于睾丸癌。它是过去几十年来在美国和欧洲发病率增加的少数癌症之一。在犹他州，15-49岁男性的年龄调整发病率从1973年的6.4增加到2007年的13.8。美国睾丸癌患者的5年生存率为96.0%，男性> 20岁（1988-2001年）。明确的睾丸癌风险因素包括年龄、对侧睾丸癌、隐睾、种族/民族和睾丸癌家族史。其他已经被研究但导致研究结果相互矛盾的因素包括较低的出生顺序，较高的母亲年龄，短的妊娠期和低出生体重。到目前为止，还没有在犹他州进行过睾丸癌的流行病学研究。犹他州人口数据库（UTB）是一个现有的数据源，为研究犹他州睾丸癌趋势、风险因素和预后提供了绝佳的机会。它已被用于乳腺癌、结直肠癌、黑色素瘤和前列腺癌的各种基因鉴定和家族聚类研究，但这将是首次将该数据库用于研究睾丸癌危险因素。此外，出生证明记录中的产前因素已被用于研究早产和自闭症谱系障碍等结果的可能风险因素，但产前因素尚未在出生证明记录中研究任何癌症。CQB拥有超过1450万条记录，这些记录与癌症登记数据、出生证明记录、死亡记录、驾驶执照记录和医疗记录有关。我们还可以获得地理编码数据，这些数据涉及特定农业活动的邻近程度（作为农药暴露的替代）以及犹他州饮用水中污染物的暴露情况，这些数据将与美国国家生物技术委员会的记录相关联。我们建议在研究中心内进行以下研究：1）睾丸癌的描述性流行病学研究，2）基于人群的病例对照研究，3）睾丸癌患者的随访研究。我们预计将包括约1,826例睾丸癌患者（1973-2007）的描述性流行病学和随访研究。在病例对照研究中，我们将纳入1，826名睾丸癌患者和5，478名对照（每个病例3名对照）。我们的具体目标与研究设计平行：1）调查犹他州人群的睾丸癌趋势，2）检查产前和围产期因素、既往病史、癌症家族史和农村居住作为睾丸癌的可能危险因素，和3）研究生存率，和第二原发肿瘤、心血管疾病的发病率，犹他州的睾丸癌患者中的抑郁症和其他疾病。这项研究将是犹他州第一个睾丸癌流行病学研究。我们将利用一个独特的现有数据资源，以促进更好地了解犹他州的睾丸癌。 公共卫生相关性：项目叙述我们在犹他州的睾丸癌项目对公共卫生很重要，因为它将有助于更好地了解随着时间的推移的趋势，风险因素对这个高危人群的睾丸癌很重要。我们还将研究睾丸癌患者的预后，并检查影响预后的因素。我们的研究结果将与犹他州预防睾丸癌的公共卫生规划有关。

DESCRIPTION (provided by applicant): Abstract The incidence rate for testicular cancer in Utah is the highest of all the cancer registries in the United States (8.3 per 100,000 in 2007). On a worldwide level, approximately 52,549 cases and 9,906 deaths occur due to testicular cancer each year. It is one of the few cancers with increasing incidence over the last few decades in the US and Europe. In Utah, the age-adjusted incidence rates for men aged 15-49 years increased from 6.4 in 1973 to 13.8 in 2007. The five year survival among testicular cancer patients in the US was 96.0% for men > 20 years old (1988-2001). The well-established testicular cancer risk factors include age, contralateral testicular cancer, cryptorchidism, race/ethnicity and family history of testicular cancer. Other factors that have been examined but have led to conflicting results across studies include lower birth order, higher maternalage, short gestational duration, and low birth weight. Thus far, an epidemiologic study on testicular cancer in Utah has never been conducted. The Utah Population Database (UPDB) is an existing data source that provides an excellent opportunity to examine testicular cancer trends, risk factors and prognosis in Utah. It has been used in various gene identifying and familial clustering studies for breast cancer, colorectal cancer, melanoma and prostate cancer, but this will be the first application of using this database for studying testicular cancer risk factors. Additionally, the UPDB has been used to study prenatal factors from birth certificate records as possible risk factors for outcomes such as preterm births and autism spectrum disorders, but prenatal factors have not been studied for any cancers thus far in the UPDB. The UPDB has over 14.5 million records with linkage across cancer registry data, birth certificate records, death records, driver's license records, and medical records. We also have access to geocoded data on proximity to specific agricultural activities (as a proxy for pesticide exposure) and exposure to contaminants in drinking water in Utah, which will be linked to the UPDB records. We propose to conduct the following studies within the UPDB: 1) a descriptive epidemiology of testicular cancers, 2) a population-based case-control study, and 3) a follow up study of testicular cancer patients. We expect to include approximately 1,826 testicular cancer patients (1973-2007) for the descriptive epidemiology and follow up studies. For the case-control study, we will include 1,826 testicular cancer patients and 5,478 controls (3 controls per case). Our specific aims are in parallel to the study designs: 1) to investigate the testicular cancer trends for the Utah population, 2) to examine prenatal and perinatal factors, history of previous disease, family history of cancer, and rural residence as possible risk factors for testicular cancer, and 3) to study survival, and incidence of second primary tumors, cardiovascular disease, depression and other diseases among testicular cancer patients in Utah. This study will be the first epidemiologic study of testicular cancer in Utah. We will take advantage of a unique existing data resource to contribute to a better understanding of testicular cancer in Utah. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Our project on testicular cancer in Utah is important for public health because it will contribute to a better understanding of the trends over time and the risk factors are important for testicular cancer in this high risk population. We will also study the prognosis of testicular cancer patients and examine what factors affect prognosis. Our results will be relevant for public health planning of prevention efforts against testicular cancer in Utah.