Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis

L Cayuela; S Cabrera Fernández; J J Pereyra-Rodríguez; J C Hernández-Rodríguez; A Cayuela

doi:10.1016/j.acuroe.2024.05.003

Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis

Actas Urol Esp (Engl Ed). 2024 May 9:S2173-5786(24)00063-5. doi: 10.1016/j.acuroe.2024.05.003. Online ahead of print.

[Article in English, Spanish]

Authors

L Cayuela¹, S Cabrera Fernández², J J Pereyra-Rodríguez³, J C Hernández-Rodríguez⁴, A Cayuela⁵

Affiliations

¹ Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Spain.
² 061 Centro de Emergencias Sanitarias, Servicio Andaluz de Salud, Sevilla, Andalucía, Spain.
³ Facultad de Medicina, Universidad de Sevilla, Spain; Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
⁴ Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
⁵ Unidad de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain. Electronic address: aurelio.cayuela@gmail.com.

PMID: 38734070
DOI: 10.1016/j.acuroe.2024.05.003

Abstract

Background: Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.

Methods: We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.

Results: A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.

Conclusion: While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

Keywords: Age-period-cohort analysis; Análisis edad-periodo-cohorte; Cáncer testicular; España; Incidence; Incidencia; Mortalidad; Mortality; Spain; Testicular cancer.