Epidemiology of testicular cancer in the Utah population

描述(申请人提供)：摘要在美国所有癌症登记中，犹他州的睾丸癌发病率最高(2007年为8.3/10万)。在世界范围内，每年约有52,549例和9,906人死于睾丸癌。它是过去几十年来在美国和欧洲发病率不断上升的少数癌症之一。在犹他州，15-49岁男性的年龄调整发病率从1973年的6.4上升到2007年的13.8。在美国，20岁男性睾丸癌患者的五年生存率为96.0%(1988-2001)。已确定的睾丸癌危险因素包括年龄、对侧睾丸癌、隐睾症、种族/民族和睾丸癌家族史。其他被检查但导致研究结果相互矛盾的因素包括较低的出生顺序、较高的母龄、较短的孕期和较低的出生体重。到目前为止，还没有对犹他州的睾丸癌进行流行病学研究。犹他州人口数据库(UPDB)是一个现有的数据源，它为研究犹他州的睾丸癌趋势、风险因素和预后提供了一个极好的机会。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识别和家族聚类研究，但这将是首次使用该数据库研究睾丸癌危险因素。此外，UPDB已被用于研究出生证明记录中的产前因素，作为早产和自闭症谱系障碍等结局的可能风险因素，但到目前为止，UPDB尚未对任何癌症的产前因素进行研究。UPDB有1450多万条记录，涉及癌症登记数据、出生证明记录、死亡记录、驾驶执照记录和医疗记录。我们还可以获得犹他州特定农业活动的地理编码数据(作为农药暴露的替代指标)和饮用水污染物暴露的地理编码数据，这些数据将与UPDB的记录相联系。我们建议在UPDB内进行以下研究：1)睾丸癌的描述性流行病学，2)基于人群的病例对照研究，以及3)对睾丸癌患者的随访研究。我们预计纳入约1,826名睾丸癌患者(1973-2007年)进行描述性流行病学和后续研究。在病例对照研究中，我们将包括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并行：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地可能是睾丸癌的危险因素，3)研究犹他州睾丸癌患者的存活率和第二原发癌、心血管疾病、抑郁症和其他疾病的发生率。这项研究将是犹他州第一次睾丸癌的流行病学研究。我们将利用现有的独特数据资源，为更好地了解犹他州的睾丸癌做出贡献。 公共卫生相关性：项目简介我们关于犹他州睾丸癌的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，而且风险因素对这一高危人群中的睾丸癌非常重要。我们还将研究睾丸癌患者的预后，并检查哪些因素影响预后。我们的研究结果将对犹他州预防睾丸癌的公共卫生规划具有重要意义。

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.