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VARIATION IN WORLDWIDE TESTICULAR CANCER MORTALITY (p 1853)

June 06, 2001

Death rates from testicular cancer remain inconsistent worldwide, with the overall trend in decreasing mortality being slower in eastern Europe compared with western Europe, USA, and Japan, conclude authors of a research letter in this week's issue of THE LANCET.

Testicular cancer is curable if treated appropriately. Fabio Levi and colleagues from the Cancer Epidemiology Unit, Lausanne, Switzerland, assessed trends of mortality from testicular cancer in Europe, the USA, and Japan. Information on death from testicular cancer was obtained from national mortality data recorded on the WHO Database.

In the European Union and the six countries of central and eastern Europe, peak mortality rates (1.6/100 000 and 1.7/100 000, respectively) were reached in the 1970's for the 20-44 age-group. In western Europe, the mortality rate has subsequently decreased by two-thirds; however, the decline in mortality has been slower - 22% - in eastern Europe. In the USA, the decrease in testicular cancer mortality has been around 70% after a peak (1.5/100000) in the late 1960s; Japan has consistently had a low mortality rate from testicular cancer , peaking at around 0.3/100000 in the late 1970s.

Fabio Levi comments: "Our findings suggest that, although platinum-based chemotherapy schemes have been available since the 1970s, the fall in testicular cancer mortality has not been consistent worldwide. The improvement in mortality has been earlier and greater in the USA than in the EU. These results support observations made for childhood cancers-when disease control depends on technological advances in medical care, North America benefits from earlier and more effective introduction of new therapeutic approaches than elsewhere. Education of both the public and health professionals, with respect to investigation of testicular abnormalities, might also be important".

Contact: Dr Fabio Levi, Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchatel, Institut Universitaire de Medecine Sociale et Preventive, CHU Falaises 1, 1011 Lausanne. Switzerland; T) 0041 21 314 72 40/0041 21 314 73 11; F) 0041 21 323 0303; E) fabio.levi@inst.hospvd.ch



Lancet




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