ORLANDO – Men with a history of testicular cancer are at higher risk for prostate cancer than men with a history of melanoma, and testicular cancer survivors also tend to have a higher incidence of higher-grade disease, investigators report.
A study of data on more than 32,000 men with a history of testicular cancer showed a cumulative incidence of prostate cancer by age 80 years of 12.6%, compared with 2.8% among more than 147,000 controls – men with a history of melanoma (P < .0001).
The incidence of intermediate- to high-risk prostate cancers was also higher among testicular cancer survivors, with a cumulative incidence by age 80 years of 5.8%, compared with 1.1% for controls (P < .0001), reported Dr. Mohummad Minhaj Siddiqui, director of urologic robotic surgery at the University of Maryland Medical Center, Baltimore.
“Based on these findings, we believe that men with history of testicular cancer should consider discussing the risks and benefits of prostate cancer screening with their physicians,” he said at a briefing prior to his presentation of the data in a scientific poster session at the Genitourinary Cancers Symposium sponsored by the American Society of Clinical Oncology.
“Further validation studies are needed to confirm these results, we believe, based on other cohorts, and to determine if men with a history of testicular cancer should have closer screening for prostate cancer in some other way,” he added.
Dr. Charles J. Ryan
Dr. Charles J. Ryan, who moderated the briefing but was not involved in the study, commented that the investigators corrected for prior radiation therapy in men with testicular cancer, suggesting that the data provide a good estimation of the actual risk.
Dr. Ryan is an ASCO Expert and is with the departments of medicine and urology at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center.
Dr. Siddiqui and his colleagues combed through Surveillance, Epidemiology and End Results (SEER) data to identify 32,435 men with a history of testicular cancer, including all subtypes.
They chose 147,044 men with a history of melanoma for the control group, because there is no known association between melanoma and prostate cancer risk.
They looked at data on men aged 40 years and older to allow for sufficient age at which prostate cancer might be diagnosed, and looked at the rate of all prostate cancer as well as intermediate-risk (Gleason score of 7), and high-risk cancers (Gleason score 8 or higher).
“We looked at alternate risk factors, such as age, race, and radiation history, and found that even when controlling for the influence of these risk factors, there was still an increased risk of developing intermediate- to high-risk prostate cancer in men with a history of testicular cancer as opposed to the control population,” Dr. Siddiqui said.
He emphasized, however, that despite the elevated risk for intermediate- to high-grade prostate cancer among testicular cancer survivors, the overall risk is relatively low; 95% of men with a history of testicular cancer will never get prostate cancer, he said.