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. 2023 Aug 17;15(16):4149.
doi: 10.3390/cancers15164149.

Predictors of Testicular Cancer Mortality in Brazil: A 20-Year Ecological Study

Ana Paula de Souza Franco  1 , Eric Renato Lima Figueiredo  1 , Giovana Salomão Melo  1 , Josiel de Souza E Souza  1 , Nelson Veiga Gonçalves  2 , Fabiana de Campos Gomes  3 , João Simão de Melo Neto  1
Affiliations

Predictors of Testicular Cancer Mortality in Brazil: A 20-Year Ecological Study

Ana Paula de Souza Franco et al. Cancers (Basel). .

Abstract

Testicular cancer is common in young men, and early detection and multimodality treatment can lead to successful outcomes. This study aims to identify sociodemographic and risk factors associated with higher testicular cancer mortality and poorer survival rates, while examining the impact of diagnostic and treatment procedures on reducing mortality. The retrospective ecological study analyzed mortality data from testicular cancer in Brazil from 2001 to 2020. Sociodemographic variables such as marital status, age, birth period, year of death (cohort), race, and geographic region were assessed. Risk factors included cryptorchidism and pesticide exposure. Data were subjected to statistical analysis, which revealed an increasing trend in mortality after 2011 among persons born after 1976 in the 15-40 age group. Individuals in the South Region, whites, and singles had higher age-standardized mortality rates (ASMRs), while singles had lower survival rates. The Northeast region had a higher survival rate. Fungicides and insecticides increase ASMR in Brazil. Herbicides increase ASMR in the Northeast and Midwest regions and insecticides increase ASMR in the Northeast, Southeast, and Midwest regions. High rates of implementation of diagnostic procedures in the Midwest were not sufficient to reduce ASMR. No treatment procedure was associated with mortality at the national or regional level.

Keywords: epidemiology; mortality registries; risk factors; testicular neoplasms.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Age–period–cohort analysis using the Wald test (A), with analysis of mortality rates (B) by age, period RR (C), cohort RR (D), and local drift (E) analysis.
Figure 2
Figure 2
Testicular cancer mortality rate by marital status (A), race (B), and geographic region (C). a,b p < 0.05, post hoc Bonferroni. * p > 0.05, post hoc Bonferroni compared to White. # p < 0.05, post hoc Bonferroni compared to Black. ° p < 0.05, post hoc Bonferroni compared to Yellow.
Figure 3
Figure 3
Survival analysis among different groups of marital status (A), racial classification (B), and geographic regions (C) using Kaplan–Meier.
Figure 4
Figure 4
Significant (p < 0.05) positive correlations (r or rs) between the ASMR in geographic regions and the use of pesticides for testicular cancer.
See this image and copyright information in PMC

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