Testicular cancer incidence statistics

Testicular cancer is the 16th most common cancer among men in the UK (2012), accounting for 1% of all new cases of cancer in males.[1-4]

In 2012, there were 2,268 new cases of testicular cancer in the UK.[1-4] The crude incidence rate Open a glossary item shows that there are 7 new testicular cancer cases for every 100,000 males in the UK.

The European age-standardised incidence rates Open a glossary item (AS rates) do not differ significantly between the constituent countries of the UK.

Testicular Cancer (C62), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, Males, UK, 2012

England Wales Scotland Northern Ireland UK
Cases 1,874 111 216 67 2,268
Crude Rate 7.1 7.4 8.4 7.5 7.2
AS Rate 6.9 7.6 8.3 7.4 7.1
AS Rate - 95% LCL 6.6 6.2 7.2 5.6 6.8
AS Rate - 95% UCL 7.2 9.0 9.4 9.1 7.4

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate. Open a glossary item
 
ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

There was considerable variation in testicular cancer incidence rates across the UK in the 1990s, with the highest rates in Scotland and southern England, and the lowest rates in London, Ireland, and parts of northern England. The latest analysis of testicular cancer incidence rates throughout the UK also reports significant variation between cancer networks, with the highest rates being in the south west, northern England, and areas of Scotland and Wales, and the lowest rates in London and eastern England.[5,6]

Geographical variation in testicular cancer incidence may reflect the ethnicity of the local population: testicular cancer risk is higher in white men compared with other ethnic groups.[7,8]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. NCIN, Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  6. Testicular cancer (C62) European age-standardised incidence rates by UK Health Boundaries, males, 2008-2010. These data were extracted from the UK Cancer Information Service, version 4.5b 001 on 06/01/2014
  7. Quinn M, Wood H, Cooper N, et al. Cancer Atlas of the United Kingdom and Ireland 1991-2000. London, Office for National Statistics; 2005
  8. Jack RH, Davies EA, Moller H. Testis and prostate cancer incidence in ethnic groups in South East England. Int J Androl 2007:30(4):215-20.
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Testicular cancer incidence is strongly related to age, but does not follow the pattern of increasing incidence with age seen for most cancers: conversely testicular cancer is most common in younger rather than older men. In the UK between 2010 and 2012, an average of 84% of cases were diagnosed in men aged 15-49 years, and 6% were diagnosed in men aged over 60 years.[1-4]

Age-specific incidence rates rise sharply from around age 15, peak in the 30-34 age group, and subsequently drop sharply, rising again in men aged 90+.[1-4] Testicular cancer is the most common cancer in men aged 25-49 in the UK (2012).

Cell changes influenced by pubertal hormones may explain why testicular cancer is more common in younger men.[5,6]

Testicular Cancer (C62), Average Number of New Cases per Year and Age-Specific Incidence Rates, Males, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. Horwich A, Shipley J, Huddart R, Testicular germ-cell cancer. Lancet 2006:367(9512):754.
  6. Rajpert-De Meyts E, Bartkova J, Samson M, et al. The emerging phenotype of the testicular carcinoma in situ germ cell. Apmis, 2003111(1):267-78.
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Testicular cancer incidence rates have overall increased in Great Britain since the late-1970s.[1-3] European age-standardised Open a glossary item (AS) incidence rates increased by 82% between 1979-1981 and 2004-2006, but have since remained stable.[1-4] Reasons for this increase remain unclear, with known risk factors and improved diagnosis or data collection unlikely to explain the trend: however worldwide variation in the trend suggests highly prevalent environmental factors may be implicated, and research is ongoing.[5]

Testicular Cancer (C62), European Age-Standardised Incidence Rates, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates have increased by 9%.[1-3,6]

Testicular Cancer (C62), European Age-Standardised Incidence Rates, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Testicular cancer incidence rates have increased overall in most adult age groups in Great Britain since the late-1970s, though generally this includes an increase followed by stability.[1-3] The largest increase has been in men aged 50-59, with European AS incidence rates increasing by 119% between 1979-1981 and 2010-2012. This overall increase included a 17% decrease in rates between 1999-2001 and 2003-2005, followed by a 36% increase since 2003-2005. In younger adult men, rates increased until the late 1990s (an 85% and 93% increase between 1979-1981 and 1999-2001 in 0-24 and 25-49 age groups, respectively) but have since remained stable.The pattern of increase in men aged 60-69 differs slightly to the other age groups as incidence rates remained stable until 2001-2003, but have since increased by 48%. In men aged 70 and over, rates have remained stable since 1979-1981.

Testicular Cancer (C62), European Age-Standardised Incidence Rates, by Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242pid=59080.
  4. Westlake S, Cooper N. Cancer incidence and mortality: trends in the United Kingdom and constituent countries, 1993 to 2004. Health Stat Q 2008:33-46.
  5. Le Cornet C, Lortet-Tieulent J, Forman D, et al. Testicular cancer incidence to rise by 25% by 2025 in Europe? Model-based predictions in 40 countries using population-based registry data. Eur J Cancer 2013. doi: 10.1016/j.ejca.2013.11.035.
  6. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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The lifetime risk of developing testicular cancer is around 1 in 195 for men, in 2012 in the UK.[1]

The lifetime risk for testicular cancer has been calculated to account for the possibility that someone can have more than one diagnosis of testicular cancer over the course of their lifetime (‘Adjusted for Multiple Primaries’ (AMP) method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries. Br J Cancer, 2011. 105(3): p. 460-5.
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The largest proportion of testicular cancer cases occur in descended testicles Open a glossary item, with a smaller proportion in undescended testicles Open a glossary item (2010-2012).[1-4] This largely reflects that undescended testicles are less common than descended testicles, and testicular cancer risk is higher in undescended testicles.

A large proportion of cases did not have further details about the affected testicle recorded in cancer registry data.[1-4]

Testicular Cancer (C62), Percentage Distribution of Cases Diagnosed By Anatomical Site, UK, 2010-2012

Cancer site (ICD-10 code) Average Cases %
Undescended Testis (C62.0) 29 1.3%
Descended Testis (C62.1) 345 15.3%
Testis, Unspecified (C62.9) 1,884 83.5%
Total 2,258 100.0%

Cases and percentages may not sum due to rounding

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerInformation/.
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95% of testicular tumours are germ-cell tumours Open a glossary item (GCTs), 4% are lymphomas Open a glossary item and the remaining 1% is composed of various rare histologies Open a glossary item. Lymphomas are nearly always found in men aged over 50 and are generally treated as a different disease entity from GCTs.

GCTs can be divided into two main groups: about 40-45% are seminomas Open a glossary item and a similar percentage are nonseminomas.

The nonseminoma group contains a variety of histological subtypes including malignant teratoma differentiated (MTD), malignant teratoma intermediate (MTI) and malignant teratoma undifferentiated (MTU).

Nonseminomas tend to occur on average ten years earlier than seminomas. Incidence of nonseminomas peaks in the 20-35 age group while incidence of seminomas peaks in the 30-45 age group. Some GCTs (10-15%) are a mixture of seminoma and nonseminoma and have a peak age incidence halfway between the nonseminomas and seminomas. They are usually classified and treated as nonseminomas.

GCTs are thought to develop from a non-invasive lesion Open a glossary item called carcinoma in situ [glossary - carcinoma in situ] (CIS) of the testis (also called intratubular germ-cell neoplasia unclassified (IGCNU) and testicular intraepithelial neoplasia (TIN)), whose malignant transformation is likely to be influenced by hormones at or after puberty.[1,2]

References

  1. Horwich A, Shipley J, Huddart R. Testicular germ-cell cancer.The Lancet, 2006. 367(9512): p. 754.
  2. Rajpert-De Meyts E, Bartkova J, Samson M, et al. The emerging phenotype of the testicular carcinoma in situ germ cell. Apmis, 2003. 111(1): p. 267-78; discussion 278-9.
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Although the incidence of testicular cancer is low throughout the world, it is estimated to have doubled in the last 40 years and there is appreciable variation between countries.[1]

The highest rates of testicular cancer are reported for white Caucasian populations in industrialised countries, particularly in western and northern Europe and Australia/New Zealand, while the disease is generally rare in non-Caucasian populations - the New Zealand Maoris being the exception.[2,3]

Testicular Cancer (C62), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

Overall, rates of testicular cancer in the developed regions of the world are five times higher than those in the less developed regions. Within North America, the consistently lower rates reported for black Americans compared with white Americans suggest a genetic component to the disease, while the rates for Asian and Hispanic men are intermediate between those of white and black Americans.[4]

Within the European Union (EU), there is an approximately five-fold variation in incidence between countries with the highest and lowest incidence rates. For example, Denmark reports age-standardised rates (ASRs) of around 10 per 100,000, while Romania and Greece have ASRs of less than 2 per 100,000. The UK ASR (6.9 per 100,000) is above the EU average.[5]

Testicular Cancer (C62), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates

Across the UK, higher rates of testicular cancer are reported in Scotland and the south of England, where incidence rates are more than 8 per 100,000 men. Rates in the north of England are around 7 per 100,000, and in eastern England and London around 6 per 100,000.[6] Lower rates recorded in urban areas may reflect the fact that urban populations generally have a higher percentage of minority ethnic groups with a lower testicular cancer risk than the general UK population.

References

  1. Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol 2003:170(1):5-11.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet] Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr. Accessed May 2011.
  3. Wilkinson TJ, Colls BM, Schluter PJ. Increased incidence of germ cell testicular cancer in New Zealand Maoris. Br J Cancer 1992:65(5):769-71.
  4. SEER. Cancer Statistics Review 1975-2003. Accessed 2006.
  5. European age-standardised rates calculated by the Statistical Information Team at Cancer Research UK, 2011 using data from GLOBOCAN 2008 v1.2, IARC, version 1.2. http://globocan.iarc.fr
  6. Statistical Information Team, Cancer Research UK, 2011: UK Cancer Information Service, version 4.3c.001, August 2011
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Data from men diagnosed in England between 2000 and 2004 show a deprivation gradient, with the highest incidence rates in the least deprived groups (7.2 cases per 100,000 in the least deprived compared with 5.5 in the most deprived).[1] However, there was no clear trend for Scottish data between 1986 and 1995.[2]

References

  1. National Cancer Intelligence Network Cancer Incidence by Deprivation, England, 1995-2004. London:NCIN; 2008.
  2. Harris V, et al. Cancer Registration Statistics: Scotland 1986-1995. Edinburgh: ISD Scotland: 1998.
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Incidence rates for White males with testicular cancer is significantly higher than rates for Asian or Black males.[1]

Analysis of the Thames Cancer Registry included unknown data. For testicular cancer, 194 590 cases were identified; 33% had no known ethnicity.

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Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 18,600 people were still alive at the end of 2006, up to ten years after being diagnosed with testicular cancer.[1]

Testicular Cancer (C62), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 1,982 9,473 18,562

Worldwide, it is estimated that there were more than 201,000 men still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN; 2010.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet] Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr. Accessed May 2011.
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