The
main objectives of this thesis were to provide information on the
epidemiology of testicular, penile and scrotal cancer by studying the
incidence, treatment, relative survival of and mortality of these tumors
and to explore whether occupational exposures are still the main risk
factor for developing scrotal cancer.
The age-standardized incidence rate of testicular cancer in the
Netherlands increased from 4.1 per
100,000 person-years in 1989 to 8.5 per 100,000 person-years in 2009.
Age-period-cohort analysis showed that this increase was mainly caused
by men of birth cohorts since 1945.
Most of the testicular cancer patients were according to the guidelines.
Relative survival of testicular cancer patients improved since the
1970’s, mainly due to introduction of cisplatin chemotherapy. In the
period 2003-2007 5-year relative survival of both European and American
seminoma testicular cancer patients younger than 50 years was at least
98%. For non-seminoma testicular cancer patients in the same age
category the survival varied between the 93% and 96%. The relative
survival of seminoma patients aged over 50 years was lower for both
seminoma and non-seminoma patients in contrast to the younger patients.
The incidence of penile cancer in the Netherlands increased slightly in
the period 1989-2006. Relative survival of penile cancer patients in
Europe and the USA has not improved since at least 1990.
The incidence of scrotal cancer in the Netherlands was very low, the
age-standardized incidence rate varied between 0.9 and 1.8 per 1,000,000
male person-years during 1989-2006.
Based on the results of two etiological studies on scrotal cancer we
believe that occupational exposure no longer has an important role in
the development of scrotal cancer.
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