TY - JOUR
T1 - Seasonal Variations in the Diagnosis of Testicular Germ Cell Tumors
T2 - A National Cancer Registry Study in Austria
AU - Tulchiner, Gennadi
AU - Staudacher, Nina
AU - Fritz, Josef
AU - Hackl, Monika
AU - Pichler, Martin
AU - Seles, Maximilian
AU - Shariat, Shahrokh F
AU - D'Andrea, David
AU - Gust, Kilian
AU - Albrecht, Walter
AU - Grubmüller, Karl
AU - Madersbacher, Stephan
AU - Graf, Sebastian
AU - Lusuardi, Lukas
AU - Augustin, Herbert
AU - Berger, Andreas
AU - Loidl, Wolfgang
AU - Horninger, Wolfgang
AU - Pichler, Renate
N1 - Funding Information:
This research was funded by the Austrian working group of Urological Oncology (AUO) of the Austrian Society for Urology (ÖGU) and by the Richard Übelhör grant of the ÖGU.
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - We conducted a retrospective National Cancer Registry study in Austria to assess a possible seasonal variation in the clinical diagnosis of testicular germ cell tumors (TGCT). In total, 3615 testicular cancer diagnoses were identified during an 11-year period from 2008 to 2018. Rate ratios for the monthly number of TGCT diagnoses, as well as of seasons and half-years, were assessed using a quasi-Poisson model. We identified, for the first time, a statistically significant seasonal trend (p < 0.001) in the frequency of monthly newly diagnosed cases of TGCT. In detail, clear seasonal variations with a reduction in the tumor incidence during the summer months (Apr-Sep) and an increase during the winter months (Oct-Mar) were observed (p < 0.001). Focusing on seasonality, the incidence during the months of Oct-Dec (p = 0.008) and Jan-Mar (p < 0.001) was significantly higher compared to the months of Jul-Sep, respectively. Regarding histopathological features, there is a predominating incidence in the winter months compared to summer months, mainly concerning pure seminomas (p < 0.001), but not the non-seminoma or mixed TGCT groups. In conclusion, the incidence of TGCT diagnoses in Austria has a strong seasonal pattern, with the highest rate during the winter months. These findings may be explained by a delay of self-referral during the summer months. However, the hypothetical influence of vitamin D3 in testicular carcinogenesis underlying seasonal changes in TGCT diagnosis should be the focus of further research.
AB - We conducted a retrospective National Cancer Registry study in Austria to assess a possible seasonal variation in the clinical diagnosis of testicular germ cell tumors (TGCT). In total, 3615 testicular cancer diagnoses were identified during an 11-year period from 2008 to 2018. Rate ratios for the monthly number of TGCT diagnoses, as well as of seasons and half-years, were assessed using a quasi-Poisson model. We identified, for the first time, a statistically significant seasonal trend (p < 0.001) in the frequency of monthly newly diagnosed cases of TGCT. In detail, clear seasonal variations with a reduction in the tumor incidence during the summer months (Apr-Sep) and an increase during the winter months (Oct-Mar) were observed (p < 0.001). Focusing on seasonality, the incidence during the months of Oct-Dec (p = 0.008) and Jan-Mar (p < 0.001) was significantly higher compared to the months of Jul-Sep, respectively. Regarding histopathological features, there is a predominating incidence in the winter months compared to summer months, mainly concerning pure seminomas (p < 0.001), but not the non-seminoma or mixed TGCT groups. In conclusion, the incidence of TGCT diagnoses in Austria has a strong seasonal pattern, with the highest rate during the winter months. These findings may be explained by a delay of self-referral during the summer months. However, the hypothetical influence of vitamin D3 in testicular carcinogenesis underlying seasonal changes in TGCT diagnosis should be the focus of further research.
UR - http://www.scopus.com/inward/record.url?scp=85117887391&partnerID=8YFLogxK
U2 - 10.3390/cancers13215377
DO - 10.3390/cancers13215377
M3 - Journal article
C2 - 34771540
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 21
M1 - 5377
ER -