Investigation of a testicular cancer cluster using a case-control approach

A case-control methodology was developed and utilized to investigate a reported cluster of testicular cancer among leather workers in New York. Eighteen cases of testicular cancer, including the three index cases, diagnosed from 1974 to 1986 among residents of two counties with substantial leather tanning and finishing establishments made up the case group. Controls (n = 259) consisted of men of similar age who had been diagnosed with cancers of all other sites during the same time period. Reports of usual occupation for cases and controls, obtained from cancer registry reports and death certificates, indicated that cases were much more likely to be leather workers (28%) than controls (7%). After adjustment for age, the relative risk estimate for occupation and testicular cancer was 7.2 (95% Cl: 1.9-27.7). The association was further supported by occupational histories showing similar work environments within the leather industry for five out of six cases known to have been leather workers. Case-control analysis of a reported cluster does not provide independent confirmation of an association between occupational factors and testicular cancer. The methodology, however, can provide a timely way to evaluate the significance of occupational cancer clusters.