Elsevier

European Journal of Cancer

Volume 51, Issue 15, October 2015, Pages 2206-2216
European Journal of Cancer

Survival of male genital cancers (prostate, testis and penis) in Europe 1999–2007: Results from the EUROCARE-5 study

https://doi.org/10.1016/j.ejca.2015.07.027Get rights and content

Abstract

Background

We provide updated estimates of survival and survival trends of male genital tumours (prostate, testicular and penis cancers), in Europe and across European areas.

Methods

The complete approach was used to obtain relative survival estimates for patients diagnosed in 2000–2007, and followed up through 2008 in 29 countries. Data came from 87 cancer registries (CRs) for prostate tumours and from 86 CRs for testis and penis tumours. Relative survival time trends in 1999–2007 were estimated by the period approach. Data came from 49 CRs in 25 countries.

Results

We analysed 1,021,275 male genital cancer cases. Five-year relative survival was high and decreased with increasing age for all tumours considered. We found limited variation in survival between European regions with Eastern Europe countries having lower survival than the others. Survival for penile cancer patients did not improve from 1999 to 2007. Survival for testicular cancer patients remained stable at high levels since 1999. Survival for prostate cancer patients increased over time.

Conclusions

Treatment standardisation and centralisation for very rare diseases such as penile cancers or advanced testicular tumours should be supported. The high survival of testicular cancer makes long-term monitoring of testicular cancer survivors necessary and CRs can be an important resource. Prostate cancer patients’ survival must be interpreted considering incidence and mortality data. The follow-up of the European Randomised Study of Screening for Prostate Cancer should continue to clarify the impact of screening on prostate cancer mortality together with population based studies including information on stage and treatments.

Introduction

Male genital tumours combined, i.e. prostate, testicular and penis cancers, show different frequency and risk factors. Prostate cancer is the most common cancer among European males [1]. The incidence rate varies by more than sevenfold (25–193 per 100,000) [2] probably because of the different use of prostate-specific antigen (PSA) test which leads to identify many non-lethal diseases and therefore to inflate incidence and survival. The rise in incidence, observed since late ‘80s, seems to have come to a halt in some countries like Finland, France and Austria [3], and mortality has levelled-off since mid-1990 [4]. Cancer of the penis is a very rare cancer with an incidence of 0.6 per 1,000,000/year [5]. Testicular cancer is rare overall, but is the most common cancer in young men and the incidence is increasing in the vast majority of European countries [6]. Its incidence rate varies at least 20-fold world-wide (>12–<1 per 100,000) [2].

With this background, this paper will contribute to the descriptive epidemiology of male genital cancers in Europe with updated estimates of survival and survival trends in Europe and across European areas.

Section snippets

Materials and methods

To estimate the relative survival (RS) for adults (age ⩾15 years) diagnosed in 2000–2007 we used:

  • for penis and testicular cancers, 86 population-based cancer registries (CRs),

  • for prostate cancers 87 CRs (we added 1 specialised CR with information on prostate) [7]. Data were from 29 countries. We included in the analyses 13,236, 56,397 and 951,642 records of penile, testicular and prostate cancers, respectively.

To analyse survival time trends from 1999 to 2007 we used 44 CRs providing data for

Penis cancers

One and 5-year RS of penile cancer patients were 86% and 68%, respectively (Fig. 1). The conditional survival was 80%. Five-year RS decreased with increasing age, from 81% in the age group 15–44 years to 62% in those aged ⩾75 years (Fig. 1).

The highest age-standardised 5-year RS was observed for Northern European patients (75%). It was 69% for those from Central, Southern Europe and Ireland/UK and it was 60% for patients from Eastern Europe. Age-standardised 5-year RS was highest for patients

Discussion

Our study confirmed a good 5-year RS for all male genital cancer patients however, the survival was lower for patients living in Eastern Europe compared to patients living in other European countries. We didn’t observe major improvement of survival for penile cancer patients. Patients with testicular cancers living in Eastern Europe didn’t reach the same high level of survival of those living in other European countries. Survival for prostate cancers increased but biases could contribute to the

Sources of support (grants)

The Compagnia di San Paolo, the Fondazione Cariplo Italy, the Italian Ministry of Health (Ricerca Finalizzata 2009, RF-2009-1529710) and the European Commission (European Action Against Cancer, EPAAC, Joint Action No 20102202).

Role of funding source

The study was funded by the Compagnia di San Paolo, the Fondazione Cariplo Italy, the Italian Ministry of Health (Ricerca Finalizzata 2009, RF-2009-1529710) and the European Commission (European Action Against Cancer, EPAAC, Joint Action No 20102202). The funding sources had no role in study design, the collection, analysis or interpretation of data, the writing of the report, or the decision to submit the article for publication.

Conflict of interest statement

None declared.

Acknowledgements

We thank Chiara Margutti, Simone Bonfarnuzzo, Camilla Amati and Lucia Buratti for secretarial assistance.

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