Trebling of the incidence of testicular cancer in Victoria, Australia (1950-1985)

Article Abstract:

Cancer of the testis is not common, but it is nevertheless of major concern, since it is the most common cancer of young men between the ages of 20 and 40. The concern is even greater because of the studies which indicate that the rate of testicular cancer is on the rise. Epidemiological studies, which attempt to look at changes in the rate of disease over time, are fraught with possible sources of error. One of the major problems is the possibility of improvements in the accuracy of diagnosis. If a disease is recognized more accurately today, it may appear in the records more frequently even if its actual frequency has not changed. For this reason, epidemiologists studying the changes in cancer incidence try to confirm the older diagnoses by finding microscopic sections in the archives and examining them again by current standards. This was done in the evaluation of testicular cancer rates in the state of Victoria, Australia. A full 97 percent of the reported cases could be confirmed under the microscope. The results showed that between 1950 and 1954, the incidence of testicular cancer was 1.44 new cases per year per 100,000 people. By the period from 1982 to 1985, the rate had risen to 4.16 new cases per 100,000 people each year, a 2.9-fold increase. The increase was limited to men under 65; among men over 65 the rate had not changed. The majority of testicular cancers (95 percent) are one of two major varieties, the seminoma and the nonseminoma; both types appear to be increasing. However, the nonseminomas appear to be increasing at a higher rate in younger men, as the incidence of nonseminomas is now highest in young men between ages 20 and 25. These results reflect the conclusions of other studies in other parts of the world, the majority of which indicate a rise in the incidence of testicular cancer. The cause of these increases in testicular cancer is not known, and, indeed, the cause may be different for seminomas and nonseminomas. There is some suggestion that testicular cancer may be associated with higher socioeconomic status, and the increase in testicular cancer in the last 40 years may represent an increasingly wide distribution of some contributory factor which was once only within the domain of the wealthy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Australia, Reports, Demographic aspects, Testicular cancer, Medical statistics

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Multivariate analysis of serum tumor markers for diagnosis of skeletal metastases

Article Abstract:

Bone is one of the tissues to which metastatic cancer cells may spread. Indeed, metastatic cancer in bone is more common than primary bone cancer. In many cases, cancer affecting bone is clearly metastatic. If the patient has already been diagnosed with a cancer known to spread to bone, the appearance of a bone tumor may be presumed to be metastasis. Similarly, the appearance of many tumors in various bones is almost certainly the result of metastatic disease. However, the appearance of a single tumor in bone may pose a diagnostic problem. A primary bone cancer should be treated with radical surgery and chemotherapy. However, inflicting these treatments on a patient whose bone cancer is metastatic serves no purpose; patients with metastatic bone cancer are generally given only palliative treatment. A study was conducted to determine if tumor markers may prove useful in distinguishing metastatic from primary bone cancer. Tumor markers are specific substances which may be found in the blood of cancer patients; while many tumor markers have been identified, none has proved completely satisfactory for the diagnosis of cancer. A panel of six tumor markers was evaluated on a group of 26 patients with metastatic bone cancer and 11 patients with primary bone cancer. The sensitivity of the six markers, that is, the fraction of cases of metastatic cancer detected by abnormal amounts of the marker, varied from a low of zero to a high of 61.5 percent. The specificity of a test is a measure of the confidence which may be placed in a positive result; 100 percent specificity means that everyone with a positive result actually has the pathologic condition. The specificities of the markers ranged from 81.8 to 100 percent in the present study. Using combined results from several markers is superior to any single marker for the diagnosis of metastatic disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Bone cancer, Tumor markers

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