Update on Epidemiologic Considerations and Treatment Trends in Testicular Cancer

Solomon L. Woldu; Aditya Bagrodia

Disclosures

Curr Opin Urol. 2018;28(5):440-447. 

In This Article

Abstract and Introduction

Abstract

Purpose of review: We aim to give an overview of the epidemiology and treatment trends of testicular germ cell tumors (TGCTs), with an emphasis on recent trends.

Recent findings: The incidence of TGCT appears to be increasing, particularly in developed countries, although the reasons are not well understood. There is evidence of racial differences in predisposition to TGCT, with white men having highest risk and men of African or Asian descent having lower risk. In the United States, the incidence of TGCT among Hispanics appears to be rising most quickly. A recent genomic analysis indicates there is no highly penetrant major TGCT susceptibility gene. Incorporation of multidisciplinary care has led to excellent long-term cure rates; however, access to care and insurance remains barriers in young men. Recent treatment trends have centered on maximizing oncologic outcomes while minimizing long-term morbidity.

Summary: Emerging population-level data provide critical insight into the evolving demographics of TGCT, which may allow for elucidation of biologic and environmental determinants of TGCT. Further, identification of socioeconomic barriers to excellent clinical outcomes will allow for targeted interventions to patients with unique demographic and socioeconomic considerations. Treatment trend analyses suggest that the field is moving toward minimizing treatment-related morbidity.

Introduction

Testicular germ cell tumors (TGCTs) are the most common malignancies affecting young men, and the incidence appears to be increasing worldwide. The advent of cisplatin-based chemotherapy, and incorporation of multidisciplinary teams of surgeons, radiologists, oncologists, radiation oncologists, and pathologists has led to dramatic improvements in cure in most cases, yet there are concerns for long-term treatment-related morbidity. Our aim is to review epidemiologic trends in TGCT, explore risk factors, and give a broad overview of treatment patterns.

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