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Long-term Testis Cancer Survivors in Canada-Mortality Risks in a Large Population-based Cohort
Arnon Lavi1, Roderick Clark1, Tina Luu Ly2
1Division of Urology, Department of Surgery, Western University, London, Ontario, Canada.
European Urology Open Science
|August 2, 2021
Summary
Testis cancer survivors face higher risks of death from secondary cancers and cardiovascular disease. Nonseminoma patients are more prone to cardiovascular death, while seminoma patients have increased risks from other malignancies.
Area of Science:
- Oncology
- Epidemiology
- Cardiovascular Disease
Background:
- Testis cancer (TC) patients are typically young with excellent prognoses.
- Long-term survival raises concerns about late-onset treatment-related morbidity and mortality.
Purpose of the Study:
- To characterize the long-term survival of TC patients using a Canadian population dataset.
- To identify specific mortality risks associated with TC histology.
Main Methods:
- Utilized the Canadian Census Health and Environment Cohort (CanCHEC) dataset (1991-2010).
- Compared mortality outcomes between 1950 TC patients and 1,300,295 individuals without TC.
- Analyzed mortality due to cardiovascular disease (CVD) and non-testicular malignancies using Cox proportional hazard models.
Main Results:
- TC patients had a 17.2% mortality rate over a mean follow-up of 19.6 years.
- Increased risk of death from secondary malignancies (HR 1.63), particularly hematologic neoplasms (HR 3.86).
- Nonseminoma (NS) patients showed increased CVD mortality risk (HR 2.03); seminoma patients had increased risk from other malignancies (HR 1.46), especially hematologic ones (HR 2.09).
Conclusions:
- Nonseminoma patients face a higher risk of cardiovascular disease-related death.
- Seminoma patients have an elevated risk of death from secondary, non-testis-related malignancies.
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