Epidemiological characteristics and trends of testicular cancer in Israel 1992-2002

Objectives: Numerous publications from Europe and North America show an increase in the incidence of testicular cancer in past years with substantial differences within and among the different countries. This study aimed to evaluate testicular cancer incidence and other epidemiologic characteristics in Israel in recent years. Methods: Incidence data was retrieved from the Israeli National Cancer Registry database. Patients with primary testicular cancer diagnosed in the years 1992-2002 were evaluated. For the sample of the year 2002, cross reference and deeper epidemiologic characterization using hospital archives was performed. Incidence rates were calculated according to age standardized, world population based standard. Analysis of variables of age, religion, origin, occupation, risk factors and histological subtypes was performed. Results: In the period of 11 years, 983 primary testicular cancer cases were diagnosed in Israeli citizens. Among Jewish men the incidence rate rose from 2.16 to 4.23/100000 while in Arabs it rose from 0.2 to 1.89/100000. Within the Jewish population the incidence rate elevation was notably prominent in immigrants from Asia and Africa. Considering the geographic distribution, in the Northern Negev changes in incidence rate were found to be more noticeable. A statistically significant decrease in the disease presentation age was observed. Germ cell testicular tumors are a leading cause of the process with an elevation of 86.2% in incidence rate from 1992 to 2002. Conclusions: The incidence of testicular cancer has increased in Israel in recent years. This trend is strongly associated with previously reported data from economically developed countries. It varies between different population groups. No single hypothesis can be put forward to account for the sudden increase in the disease incidence.