Epidemiology and treatment delay in testicular cancer patients: a retrospective study

Abstract

Introduction: Testicular cancer (TC) is a quite rare malignancy, although its medical importance is growing due to a rapid growth in incidence. The recent age-adjusted incidence in the Slovak Republic attained 6.9/100,000; mortality was 0.4/100,000. Incidence has increased by 80% in the period 1968-2003. Diagnostic and treatment delay may have an impact on overall survival.

Materials and methods: A national descriptive study evaluating the data of patients with TC diagnosed in Slovakia in the period 1993-2002 was designed. Patients were analyzed using medical questionnaires, case histories, clinical symptoms, parameters such as data of treatment onset and treatment approaches, histology of the tumor, the stage of disease, response to treatment, and the follow-up period in all 1,832 cases of TC.

Results: The average incidence (1993-2002) was 6.2/100,000; mortality was 0.5/100,000. The median follow-up time of the patients with TC was 112.5 months, overall survival was 91% and 5-year survival was 96.2%. Mortality decrease and survival improvement, despite the incidence increase, are the result of not only an effective treatment, but also early diagnosis of each case. The overall treatment delay (mean time of 150 days) shows that young males are generally poorly informed about the possibility of TC occurrence.

Conclusion: The only methods to decrease the mortality of patients with TC, can be early detection and risk-adapted treatment in specialized centers according to the histology and clinical stage using standardized guidelines and long-term follow-up of patients with this malignancy.