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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Testicular cancer (TC) is the most common malignancy among men aged 15-34 years. During the past several decades, numerous studies have reported a temporal upward trend in the incidence of TC in many countries in North America and Europe. The etiology, however, remains poorly understood, with the only well documented risk factors being cryptorchdism, prior history of TC and family history of TC. TC is a highly treatable, often curable cancer with a cure rate that exceeds 90%. The high survival rate and the young age of TC patients highlight the importance of assessing late morbidity and quality of life (QoL). There are currently approximately 140,000 men who have survived TC living in the U.S. However, very few studies have been conducted in the U.S. to systematically examine long-term morbidity and the QoL of TC survivors, while the group of survivors is growing. The impact of culture and treatment modalities specific to the U.S. demands that we investigate this topic in the U.S. population. Through a collaborative effort with investigators at the National Cancer Institute (NCI), we would like to conduct a cross-sectional survey of QoL issues in a recently completed case-control study involving 754 TC cases and 928 healthy controls. The population included in the STEED (Servicemen's Testicular tumor Environmental Endocrine Determinants) Study presents an opportunity to improve our understanding of the long-term complications associated with TC survival. Treatment advances in the early 1990s have lead to almost equal survival rates in patients with comparable extent of TC. As such, in patients with low-risk disease, other parameters, such as side effects and long-term health-related QoL outcomes determine the choice of treatment. We will subsequently assess what factors affect the QoL outcomes of TC survivors. This study will be the first study of QoL and long-term morbidity in the TC survivor population in the United States since the 1990s, during which a new technique RPLND was introduced to TC patient treatment. We think that the addition of a QoL study to the etiologic epidemiologic study conducted by the NCI will make a significant contribution to the literature and the understanding of TC survivorship. The increasing incidence of TC in young men, and the high survival rate, makes understanding the morbidity associated with TC survival a public health priority.