CANCER of the TESTIS Data Highlights The 1992-96 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 1995. 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 1996. The average annual age-specific incidence rates for testicular cancer for 1992-96 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 1996. Early stage at the time of diagnosis and advances in therapy have resulted in greatly improved five-year relative survival rates. The average annual (1992-96) 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, 1992-1996 Incidence Mortality Race All Males.2 4.6.2 5.1.1.9 1 2 3 4 5 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 1992-1996 - Page 14
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, 1987-1996 All Males* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- 1996 311 4.6.5 31 5..6 6 1..8 1995 329 4.8.5 317 5.2.6 7 1.1.8 1994 38 4.5.5 32 4.9.6 2.3.4 1993 34 5..5 33 5.5.6 6 1.1.9 1992 29 4.2.5 283 4.6.5 6.9.7 1991 317 4.6.5 36 5..6 8 1.4 1. 199 311 4.5.5 3 4.9.6 9 1.8 1.2 1989 34 4.4.5 298 4.8.5 3.4.5 1988 268 3.9.5 259 4.2.5 7 1.4 1. 1987 285 4.2.5 276 4.5.5 7 1.3 1. * 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, 1987-1996 6 4 Rate per 1, 2 1987 1988 1989 199 1991 1992 1993 1994 1995 1996 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 141
Cancer of the Testis: INCIDENCE TABLE 16-B Average Annual Age-Specific Incidence Rates by Race Age Group All Males White Black Total 5.5 5.9 1. Under 5.3.4-5-9. -.4 1-14.2.2-15-19 2.6 2.9.4 2-24 8.2 9. 1.7 25-29 12.5 13.9 2.2 3-34 15.2 16.9 1.8 35-39 14.1 15.4 2. 4-44 8.1 8.6 2.3 45-49 4.7 5. 2.8 5-54 3. 3.3-55-59 2. 2.1-6-64 1.7 1.9-65-69 1. 1.1-7-74.7.6-75-79.9 1. - 8-84 1.8 1.9-85+ 3. 3.2 - NOTE: Rates are per 1, male population (1992-1996) for each specified group. FIGURE 16-B Average Annual Age-Specific Incidence Rates by Race 2 15 Rate per 1, 1 5 Under 5 5-9 1-14 2-24 3-34 4-44 15-19 25-29 35-39 Age Group 5-54 45-49 6-64 7-74 8-84 55-59 65-69 75-79 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 142
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 1,533 27 Under 5 7 7 5-9 1 1 1-14 4 4 15-19 55 53 1 2-24 172 163 4 25-29 261 254 5 3-34 348 343 4 35-39 327 319 4 4-44 177 17 4 45-49 88 84 4 5-54 46 46 55-59 27 26 6-64 22 22 65-69 12 12 7-74 7 6 75-79 7 7 8-84 8 8 85+ 9 9 * Includes any unknowns. FIGURE 16-C Stage at Diagnosis, Percent by Race Pennsylvania Male Residents, 1996 8 71.4 66.7 In Situ Local Regional 6 Distant Percent 4 33.3 2 18. 1.5 White males Black males Number and Percent of Cases Microscopically Confirmed: 39-99.4% Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 143
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, 1987-1996 All Males* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- 1996 8.1.1 8.1.1 - - 1995 14.2.1 12.2.1 1.1.2 1994 17.3.1 16.3.1 1.2.4 1993 18.3.1 16.3.1 1.1.2 1992 22.3.1 21.4.2 1.2.4 1991 11.1.1 11.2.1 - - 199 22.3.1 2.3.1 2.4.6 1989 2.3.1 19.3.1 1.2.4 1988 13.2.1 12.2.1 - - 1987 28.4.1 26.4.2 1.3.6 * 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, 1987-1996.5.4 Rate per 1,.3.2.1 1987 1988 1989 199 1991 1992 1993 1994 1995 1996 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 144
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* 79.3 73.3 4.1 Under 5 - - - 5-9 - - - 1-14 - - - 15-19 1. 1.1-2-24 7.3 7.4-25-29 19.9 16.9 1.4 3-34 13.6 13.6-35-39 8.3 7.3 1.5 4-44 1.5 9.5 1.6 45-49 8.4 7.4 1.7 5-54 2.1 2.1-55-59 3.2 3.2-6-64 2.2 2.2-65-69 3.2 3.3-7-74 - - - 75-79 1.1 1.1-8-84 1.2 1.2-85+ 1.3 1.4 - * Includes any unknowns. NOTE: Rates are per 1, male population (1992-1996) for each specified group. 2 FIGURE 16-E Average Annual Age-Specific Death Rates by Race Rate per 1, 1 Under 5 5-9 1-14 2-24 3-34 4-44 5-54 6-64 7-74 8-84 15-19 25-29 35-39 45-49 55-59 65-69 75-79 Age Group 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 145
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 1,578 4.6.2 Adams 12 5. 2.8 Juniata 4 5.9 5.8 Allegheny 134 3.7.6 Lackawanna 4 7. 2.2 Armstrong 12 5.7 3.2 Lancaster 72 6. 1.4 Beaver 17 3.6 1.7 Lawrence 11 4.6 2.7 Bedford 6 3.9 3.1 Lebanon 18 5.6 2.6 Berks 55 5.4 1.4 Lehigh 49 5.8 1.6 Blair 16 4.5 2.2 Luzerne 48 5.6 1.6 Bradford 5 2.6 2.3 Lycoming 14 4. 2.1 Bucks 92 5.2 1.1 McKean 7 4.7 3.5 Butler 17 3.4 1.6 Mercer 19 5.5 2.5 Cambria 26 6.2 2.4 Mifflin 3 2.7 3.1 Cameron - - Monroe 16 4.2 2.1 Carbon 9 5. 3.3 Montgomery 12 5.6 1. Centre 14 3.1 1.6 Montour 4 6.1 6. Chester 55 4.9 1.3 Northampton 38 5.1 1.6 Clarion 2 1.7 2.4 Northumberland 14 5.4 2.8 Clearfield 9 3.8 2.5 Perry 5 3.2 2.8 Clinton 5 4.9 4.3 Philadelphia 139 3.3.5 Columbia 7 3.7 2.7 Pike 2 1.7 2.4 Crawford 14 6.1 3.2 Potter 1 2.3 4.5 Cumberland 26 4.2 1.6 Schuylkill 22 5.4 2.3 Dauphin 41 5.9 1.8 Snyder 2 1.9 2.6 Delaware 59 3.7.9 Somerset 12 5.6 3.2 Elk 2 2.3 3.2 Sullivan - - Erie 41 5.4 1.7 Susquehanna 2 1.5 2.1 Fayette 12 2.9 1.6 Tioga 9 8.4 5.5 Forest 1 7.4 14.5 Union 2 1.3 1.8 Franklin 17 5.1 2.4 Venango 9 5.6 3.7 Fulton 2 5.5 7.6 Warren 7 5. 3.7 Greene 4 3. 2.9 Washington 31 5.5 1.9 Huntingdon 11 7.9 4.7 Wayne 14 11.6 6.1 Indiana 9 3.4 2.2 Westmoreland 51 5. 1.4 Jefferson 5 4.5 3.9 Wyoming 4 4.3 4.2 York 52 5.3 1.4 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 1992-1996 - Page 146
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 79.2. Adams 1.4.8 Juniata - - Allegheny 4.1.1 Lackawanna 2.4.6 Armstrong 1.4.8 Lancaster 6.5.4 Beaver 1.2.4 Lawrence 1.4.8 Bedford - - Lebanon 1.2.4 Berks 2.2.3 Lehigh - - Blair - - Luzerne 1.2.4 Bradford - - Lycoming 1.3.6 Bucks 5.3.3 McKean - - Butler 1.2.4 Mercer 1.3.6 Cambria - - Mifflin 1.8 1.6 Cameron - - Monroe - - Carbon - - Montgomery 7.3.2 Centre 1.2.4 Montour 1 1.5 2.9 Chester 1.1.2 Northampton 3.4.5 Clarion - - Northumberland 3 1.1 1.2 Clearfield - - Perry - - Clinton 2 2. 2.8 Philadelphia 7.2.1 Columbia - - Pike - - Crawford 1.4.8 Potter - - Cumberland 1.2.4 Schuylkill 1.2.4 Dauphin 5.7.6 Snyder - - Delaware 3.2.2 Somerset 1.5 1. Elk - - Sullivan - - Erie 1.1.2 Susquehanna - - Fayette - - Tioga - - Forest - - Union - - Franklin - - Venango 1.7 1.4 Fulton 1 2.4 4.7 Warren - - Greene - - Washington 2.3.4 Huntingdon 1.6 1.2 Wayne - - Indiana - - Westmoreland 4.4.4 Jefferson - - Wyoming - - York 3.3.3 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 1992-1996 - Page 147