Introduction

Testicular germ cell tumor is the most common cancer in young men, and its incidence has been increasing. The standard therapy for advanced testicular cancer is multi-agent chemotherapy comprising bleomycin, etoposide, and cisplatin. However, opportunities for a regimen consisting of etoposide, ifosfamide, and cisplatin increase in consideration of the risk of pulmonary toxicity from bleomycin, particularly among older men. This study therefore retrospectively examined trends over time in the age at diagnosis of testicular cancer.

Methods

A total of 478 patients were diagnosed with and underwent treatment for testicular cancer at our institution between January 1980 and May 2016. Patients were divided into 4 groups according to the year of diagnosis: 1980 to 1989; 1990 to 1999; 2000 to 2009; and 2010 to 2016.

Results

Median age at diagnosis continuously increased, from 27 years (n=53) to 31 years (n=135), 34 years (n=179) and 38 years (n=111) in each period, respectively. Next, patients were divided by pathological type into 2 groups: a seminoma group with pure seminoma (n=227; 47.5%); and a non-seminoma group with non-seminoma or mixed germ cell tumor (n=251; 52.5%). In the seminoma group, median age increased constantly from 31 years (n=20) to 34 years (n=54), 36 years (n=93) and 41 years (n=60) in each period, respectively. Median age in the non-seminoma group also increased constantly from 26 years (n=33) to 28 years (n=81), 29 years (n=86) and 35 years (n=51) in each period, respectively. Interestingly, a continuous increase was also seen in the relative proportion of seminomas, from 37.7% to 40.0%, 52.0%, and 54.0% in each period, respectively.

Conclusions

The age at diagnosis is rising for patients with testicular cancer, and the age of patients with testicular cancer may increase in future. This should be kept in mind for the decision-making process leading to chemotherapy for testicular cancer.

Funding

none