FIGURE 16 Average Annual Age-Adjusted Incidence and Mortality Rates* by Race, Pennsylvania Residents, Age-Adjusted Rate

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1 CANCER of the TESTIS Data Highlights The average annual age-adjusted incidence rate for testicular cancer was 5.1 per 1, for whites, compared to.9 for blacks. In 1996, there were 311 testicular cancer cases diagnosed among male residents of Pennsylvania, a 5.5 percent decrease from the 329 reported in White males accounted for 31 or 96.8 percent of all the cases. While cancer of the testis represented.9 percent of all the cancers diagnosed among males, it was the most common type of malignancy among males under 45 years of age in The average annual age-specific incidence rates for testicular cancer for were highest for male residents between the ages of 15 and 54. Annual numbers of cases and age-adjusted incidence rates from 1987 to 1996 showed slightly higher figures for white males in recent years. Seventy-one percent of the cases reported for 1996 were diagnosed at the localized stage of the disease. There were 8 testicular cancer deaths among Pennsylvania males in 1996 that were due to cancer of the testis, for an age-adjusted mortality rate of.1 per 1,. All eight testicular cancer deaths were for white males. There were no discernable trends in the annual age-adjusted death rates from 1987 through Early stage at the time of diagnosis and advances in therapy have resulted in greatly improved five-year relative survival rates. The average annual ( ) age-specific mortality rates for testicular cancer were highest for the ages 25 to 44. FIGURE 16 Average Annual Age-Adjusted Incidence and Mortality Rates* by Race, Pennsylvania Residents, Incidence Mortality Race All Males Age-Adjusted Rate Risk Factors Cryptorchidism. Testicular atrophy. Etiological factors are obscure. *per 1, 197 U.S. standard million population. Early Detection Screening for testicular cancer may be beneficial but conclusive evidence of a benefit is lacking. The American Cancer Society recommends that testicular examinations be included as part of the periodic health examination of men. The Canadian Task Force recommends that screening should be only on patients with a history of cryptorchidism, testicular atrophy or orchioplexy. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 14

2 Cancer of the Testis: INCIDENCE TABLE 16-A Number of Cancer Cases, Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by Race and Year, Pennsylvania Male Residents, All Males* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/ * Includes any unknowns. NOTES: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. Rates based on less than 2 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the ageadjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). FIGURE 16-A Age-Adjusted Incidence Rates by Race Pennsylvania Male Residents, Rate per 1, Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 141

3 Cancer of the Testis: INCIDENCE TABLE 16-B Average Annual Age-Specific Incidence Rates by Race Age Group All Males White Black Total Under NOTE: Rates are per 1, male population ( ) for each specified group. FIGURE 16-B Average Annual Age-Specific Incidence Rates by Race 2 15 Rate per 1, 1 5 Under Age Group Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 142

4 Cancer of the Testis: INCIDENCE TABLE 16-C Total Number of Cases by Age and Race Age Group All Males* White Black Total 1,578 1, Under * Includes any unknowns. FIGURE 16-C Stage at Diagnosis, Percent by Race Pennsylvania Male Residents, In Situ Local Regional 6 Distant Percent White males Black males Number and Percent of Cases Microscopically Confirmed: % Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 143

5 Cancer of the Testis: MORTALITY TABLE 16-D Number of Deaths, Age-Adjusted Death Rates and Range for 95% Confidence Intervals by Race and Year, Pennsylvania Male Residents, All Males* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/ * Includes any unknowns. NOTES: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. Rates based on less than 2 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the ageadjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). FIGURE 16-D Age-Adjusted Death Rates by Race Pennsylvania Male Residents, Rate per 1, Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 144

6 Cancer of the Testis: MORTALITY TABLE 16-E Number of Deaths and Average Annual Age-Specific Deaths Rates by Race All Males* White Black Age Group No. Rate No. Rate No. Rate Total* Under * Includes any unknowns. NOTE: Rates are per 1, male population ( ) for each specified group. 2 FIGURE 16-E Average Annual Age-Specific Death Rates by Race Rate per 1, 1 Under Age Group 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 145

7 Cancer of the Testis: INCIDENCE TABLE 16-F Number of Cases, Average Annual Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by County, M a l e s M a l e s County No. Rate CI+/- County No. Rate CI+/- All Counties 1, Adams Juniata Allegheny Lackawanna Armstrong Lancaster Beaver Lawrence Bedford Lebanon Berks Lehigh Blair Luzerne Bradford Lycoming Bucks McKean Butler Mercer Cambria Mifflin Cameron - - Monroe Carbon Montgomery Centre Montour Chester Northampton Clarion Northumberland Clearfield Perry Clinton Philadelphia Columbia Pike Crawford Potter Cumberland Schuylkill Dauphin Snyder Delaware Somerset Elk Sullivan - - Erie Susquehanna Fayette Tioga Forest Union Franklin Venango Fulton Warren Greene Washington Huntingdon Wayne Indiana Westmoreland Jefferson Wyoming York NOTES: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. Rates based on less than 2 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 146

8 Cancer of the Testis: MORTALITY TABLE 16-G Number of Deaths, Average Annual Age-Adjusted Death Rates and Range for 95% Confidence Intervals by County, M a l e s M a l e s County No. Rate CI+/- County No. Rate CI+/- All Counties Adams Juniata - - Allegheny Lackawanna Armstrong Lancaster Beaver Lawrence Bedford - - Lebanon Berks Lehigh - - Blair - - Luzerne Bradford - - Lycoming Bucks McKean - - Butler Mercer Cambria - - Mifflin Cameron - - Monroe - - Carbon - - Montgomery Centre Montour Chester Northampton Clarion - - Northumberland Clearfield - - Perry - - Clinton Philadelphia Columbia - - Pike - - Crawford Potter - - Cumberland Schuylkill Dauphin Snyder - - Delaware Somerset Elk - - Sullivan - - Erie Susquehanna - - Fayette - - Tioga - - Forest - - Union - - Franklin - - Venango Fulton Warren - - Greene - - Washington Huntingdon Wayne - - Indiana - - Westmoreland Jefferson - - Wyoming - - York NOTES: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. Rates based on less than 2 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 147