Epidemiology of Uncommon Male Genital Cancers: Studies with regional, national and international cancer registry data

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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