Testicular cancer survival in Estonia: Improving but still relatively low

Figures & data

Table I. Number of patients diagnosed with testicular cancer in Estonia in five periods between 1980 and 2003 and included in survival analysis, by age group and tumour morphology.

	Number of patients
	1980–84	1985–89	1990–94	1995–99	2000–03	Total (%)
Age (years)
15–29	15	16	18	31	34	114 (34.3)
30–44	19	18	33	33	27	130 (39.2)
≥45	20	19	16	26	7	88 (25.5)
Morphology
Seminoma	32	31	40	47	27	177 (53.3)
Non-Seminoma	18	21	24	37	37	137 (41.3)
Other and unspecified	4	1	3	6	4	18 (5.4)
All	54	53	67	90	68	332 (100.0)

Table II. Five-year period relative survival point estimates with 95% confidence interval (CI) for patients diagnosed with testicular cancer in Estonia in four periods between 1985 and 2004, and p-values for trend between 1985–1989 and 2000–2004, by age group and tumour morphology.

	Survival, % (95% CI)				p-value for trend
	1985–89	1990–94	1995–99	2000–04
Age (years)
15–29	49.5 (24.0–75.0)	71.6 (49.8–93.4)	62.8 (44.0–81.6)	93.3 (85.5–101.1)	<0.01
30–44	47.7 (21.4–74.0)	79.4 (64.5–94.3)	77.6 (62.9–92.3)	79.9 (65.2–94.6)	0.07
≥45	44.9 (21.8–68.0)	32.2 (5.5–58.9)	60.4 (36.5–84.3)	41.1 (7.8–74.4)	0.47
Morphology
Seminoma	51.5 (30.9–72.1)	68.8 (51.7–85.9)	77.6 (63.3–91.9)	78.5 (64.0–93.0)	0.02
Non-seminoma	46.6 (24.8–68.4)	67.4 (48.2–86.6)	62.2 (45.3–79.1)	84.1 (72.1–96.1)	<0.01
All patients	49.5 (34.6–64.4)	66.5 (53.8–79.2)	68.6 (57.8–79.4)	81.8 (72.2–91.4)	<0.01
All patients^1	47.9 (33.6–62.2)	59.8 (46.3–73.3)	67.8 (56.4–79.2)	74.5 (59.2–89.8)	<0.01

¹Age-adjusted estimate.

Table III. Stage distribution of seminomatous and non-seminomatous testicular cancers diagnosed in Estonia in 1990–2003, by age group.

Morphology, stage	Percentage of patients
	Age 15–29	Age ≥30
Seminoma
I	64	64
II	18	19
III	18	15
NS^1	0	2
Non-seminoma
I	40	33
II	35	29
III	23	36
NS	2	2

¹Stage not specified.

Table IV. Selected diagnostic characteristics among patients diagnosed with testicular cancer in Estonia in three periods between 1990 and 2003, and p-values for trend between 1990–1994 and 2000–2003.

Diagnostic tests used	Percentage of patients			p-value for trend
	1990–94	1995–99	2000–03
Chest x-ray or CT^1	92	80	96	0.55
Abdominal or pelvic USG^2	62	69	16	<0.01
Abdominal CT
age 15–29	11	68	100	<0.01
age ≥30	4	48	85	<0.01
Pelvic CT
age 15–29	0	58	100	<0.01
age ≥30	2	37	79	<0.01
Alpha-fetoprotein
age 15–29	17	58	97	<0.01
age ≥30	6	55	74	<0.01
Human chorionic gonadotropin
age 15–29	17	58	97	<0.01
age ≥30	6	52	74	<0.01
Lactate dehydrogenase
age 15–29	0	29	85	<0.01
age ≥30	0	18	68	<0.01

¹Computerised tomography.

²Ultrasound sonography.

Table V. Selected treatment characteristics among patients diagnosed with testicular cancer in Estonia in three periods between 1990 and 2003, and p-values for trend between 1990–1994 and 2000–2003.

Treatment methods used	Percentage of patients			p-value for trend
	1990–94	1995–99	2000–03
RPLND^1
Seminoma	5	6	21	0.04
Non-seminoma	48	45	58	0.38
All	21	22	43	<0.01
Radiotherapy
Seminoma	51	50	54	0.87
Non-seminoma	8	5	6	0.72
All	33	27	26	0.38
Chemotherapy
Seminoma	46	41	43	0.76
Non-seminoma	72	84	89	0.09
All	56	58	68	0.17
Platinum-based regimens^2	78	77	98	0.01

¹Retroperitoneal lymphnode dissection.

²Among patients undergone chemotherapy.

Table VI. Trends in mortality and survival in testicular cancer in selected European countries between 1990–1994 and 2000–2004.

Country	Age-standardised (world) mortality rate per 100 000^1			5-year relative survival, %^2
	1990–94	2000–04	Change	1990–94	2000–04	Change % units
Poland^3	0.8	0.5	–0.3	59.7	86.5	26.8
Estonia	0.6^4	0.5	–0.1	59.8	74.5	17.4
Slovenia	0.5	0.5	0.0	88.6	93.6	5.0
Norway	0.3	0.4	0.1	94.6	93.9	–0.7
Finland	0.2	0.2	0.0	88.4	92.9	4.3

¹Based on the World Health Organisation Cancer Mondial Information System (http://www-dep.iarc.fr).

²Based on EUNICE Survival study [14].

³Survival data only for Cracow.

⁴Data only for 1994.

Figure 1. Percentage change in the age-standardised (world) incidence and mortality for testicular cancer in Estonia between 1980–1984 and 2000–2004, by the age group. The incidence is based on the Estonian Cancer Registry; the mortality is based on the Estonian Cancer Registry (1980–1984) and the World Health Organisation Cancer Mondial Information System, http://www-dep.iarc.fr (2000–2004).

Gondos A, Bray F, Hakulinen T, Brenner H, the EUNICE Survival Working Group. Trends in cancer survival in 11 European populations from 1990 to 2009: A model-based analysis. Ann Oncol 2009;20:564–73.

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