Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany

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Abstract

Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany.

Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as 564 suitable controls (from a pool of other cancers) were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR) and associated 95% confidence intervals (CI).

Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63) and for clerical support workers (OR 1.71, 95% CI 1.14–2.56). This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33) and clerks (OR 2.00, 95% CI 1.30–3.09), respectively. An association with testicular cancer was observed for no other occupation.

Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach.

Zusammenfassung

Ziele: Hodenkrebs betrifft vor allem junge Männer im Alter von unter 50 Jahren. Ein Zusammenhang zwischen erhöhtem Auftreten von Hodenkrebs und Beruf bzw. sozialem Status wurde untersucht (in Betracht gezogen), aber die Risikofaktoren sind bislang noch nicht umfassend erforscht. Eine Register-basierte Fall-Kontroll-Studie zur Untersuchung eines Zusammenhangs von beruflicher Erwerbstätigkeit und Hodenkrebs wurde in Deutschland durchgeführt.

Methoden: 348 Hodenkrebsfälle mit den verfügbaren Informationen zur Erwerbstätigkeit zwischen 2000 und 2005, sowie 564 geeignete Kontrollen (aus einem Pool anderer Krebsarten) wurden aus dem Krebsregister Rheinland-Pfalz gezogen. Mittels einer unkonditionalen logistischen Regression wurden Odds Ratios (OR) und deren 95%-Konfidenzintervall (CI) berechnet.

Ergebnisse: Eine leichte Erhöhung wurde für Techniker und verwandte Berufe (OR 1,62, 95% CI 1,00 bis 2,63) und für Bürokräfte (OR 1,71, 95% CI 1,14 bis 2,56) beobachtet. Dieser Anstieg war am höchsten in der Altersgruppe 20–50 für Techniker (OR 2,02, 95% CI 1,23 bis 3,33) sowie für Bürokräfte (OR 2,00, 95% CI 1,30 bis 3,09). Es wurde keine weitere Assoziation zwischen Hodenkrebs und anderen Berufen beobachtet.

Fazit: Ein erhöhtes Risiko für Hodenkrebs wurde für Techniker und verwandte Berufe sowie für Bürokräfte beobachtet. Dies könnte auf den sozioökonomischen Status bzw. die bewegungsarme Lebensweise zurückgeführt werden, was auch schon in früheren Studien gezeigt wurde. Während die Machbarkeit einer rein Register-basierten Studie gezeigt wurde, stellen die fehlenden beruflichen Daten sowie die Wahl der Krebskontrollen eine Herausforderung für die Richtigkeit dieses Ansatzes dar.

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Most cited references 46

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International trends in the incidence of testicular cancer, 1973-2002.

Mark Purdue, Kate B Cook, Elizabeth A McGlynn … (2010)

Whereas testicular cancer incidence rates have been widely reported in populations of Northern European ancestry, rates in other populations have been less frequently examined. In a prior report, global testicular cancer incidence rates and trends for the years 1973 to 1997 were summarized. The current report extends these analyses with an additional 5 years of data from Cancer Incidence in Five Continents. Age-standardized incidence rates over successive 5-year time periods were obtained for populations in the Americas, Asia, Europe, and Oceania. In general, testicular cancer incidence remained highest in Northern European populations (8.0-9.0 per 100,000) and lowest in Asian and African populations (<1 per 100,000). One notable exception to this pattern, however, was the very high rate reported by the Valdivia, Chile registry (8.8 per 100,000). In many populations, rates rose between 1973 and 2002, although the increases were strongest and most consistent among populations of European ancestry. In certain European populations, such as those of Denmark and of Geneva, Switzerland, some recent plateauing of rates was evident. There was little evidence of increase and possible evidence of a modest decline in rates among east Asian populations. Trends by histology (seminoma and nonseminoma) were generally similar to one another. Risk of testicular cancer remains relatively high in Northern European populations and low in Asian and African populations. Similar trends by histology suggest common risk factors. EFFECT: Reasons for increasing rates among Northern Europeans and stable or declining rates among East Asians are unexplained, supporting the need for future etiologic studies. Copyright (c) 2010 AACR

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Trends in testicular cancer incidence and mortality in 22 European countries: continuing increases in incidence and declines in mortality.

Martina Cuninkova, Freddie Bray, Henrik Møller … (2006)

This study profiles testicular cancer incidence and mortality across Europe, and the effects of age, period and generational influences, using age-period-cohort modeling. Despite a 5-fold variation in incidence rates, there were consistent mean increases in incidence in each of the 12 European countries studied, ranging from around 6% per annum (Spain and Slovenia) to 1-2% (Norway). In contrast, declines in testicular cancer mortality of 3-6% per annum were observed in the 1980s and 1990s for the majority of the 22 countries studied, particularly in Northern and Western Europe. The mortality trends in several European countries were rather stable (Romania and Bulgaria) or increasing (Portugal and Croatia). Short-term attenuations in increasing cohort-specific risk of incidence were indicated among men born between 1940 and 1945 in 7 European countries. In Switzerland, successive generations born from the mid 1960s may have experienced a steadily declining risk of disease occurrence. While the underlying risk factors responsible remain elusive, the temporal and geographical variability in incidence may point to an epidemic in different phases in different countries-the result of country-specific differences in the prevalence of one or several ubiquitous and highly prevalent environmental determinants of the disease. Advances in treatment have led to major declines in mortality in many European countries from the mid 1970s, which has translated to cohorts of men at successively lower risk of death from the disease. Slower progress in the delivery of optimal care is however evident from the mortality trends in several lower-resource countries in Southern and Eastern Europe. The first beneficiaries of therapy in these populations may be those men born--rather than diagnosed--in the era of major breakthrough in testicular cancer care. Copyright 2006 Wiley-Liss, Inc.

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Epidemiology and prevention of pancreatic cancer.

A Lowenfels, Patrick Maisonneuve (2004)

Pancreatic cancer is an uncommon tumor, but because the mortality rate approaches 100%, this form of cancer has now become a common cause of cancer mortality. In the United States it is the fourth most frequent cause of cancer mortality; in Japan it ranks as the fifth commonest cause of death from cancer. Smoking is the major known risk factor for pancreatic cancer, accounting for approximately 25-30% of all cases. Some of the time-dependent changes in the frequency of pancreatic cancer can be explained by smoking trends. Aggressive public health measures to control smoking would substantially reduce the burden of pancreatic cancer. Dietary factors are less important for pancreatic cancer than for other digestive tract tumors, but consumption of a diet with adequate quantities of fruits and vegetables, plus control of calories either by dietary measures or by exercise will help to prevent this lethal tumor. There are more than a dozen inherited germline mutations that increase the risk of pancreatic cancer. Of these, hereditary pancreatitis confers the greatest risk, while BRCA2 mutations are the commonest inherited disorder. In addition to germline defects, there are several common polymorphisms in genes that control detoxification of environmental carcinogens that may alter the risk of pancreatic cancer. More research will be needed in this area, to explain and to clarify the interaction between genes and environmental factors.

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Author and article information

Journal

Journal ID (nlm-ta): Ger Med Sci

Journal ID (iso-abbrev): Ger Med Sci

Journal ID (publisher-id): GMS Ger Med Sci

Title: GMS German Medical Science

Publisher: German Medical Science GMS Publishing House

ISSN (Electronic): 1612-3174

Publication date (Electronic): 12 November 2013

Publication date Collection: 2013

Volume: 11

Electronic Location Identifier: Doc16

Affiliations

[1 ]Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany

[2 ]Cancer Registry of Rhineland-Palatinate, Mainz, Germany

[3 ]Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany

Author notes

*To whom correspondence should be addressed: Lamyaa Yousif, Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, 55101 Mainz, Germany, E-mail: yousif@ 123456daad-alumni.de

Article

Publisher ID: 000184 Publisher Item ID: Doc16 Other ID: urn:nbn:de:0183-0001841

DOI: 10.3205/000184

PMC ID: 3836396

SO-VID: f2d7ad02-b111-4e4a-9ceb-87b413b3bc20

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/). You are free to copy, distribute and transmit the work, provided the original author and source are credited.

History

Date received : 06 May 2013

Date revision received : 03 October 2013

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Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany

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China Occupational Medicine

Most cited references 46

International trends in the incidence of testicular cancer, 1973-2002.

Trends in testicular cancer incidence and mortality in 22 European countries: continuing increases in incidence and declines in mortality.

Epidemiology and prevention of pancreatic cancer.

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