Seasonal Variations in the Diagnosis of Testicular Germ Cell Tumors: A National Cancer Registry Study in Austria

Gennadi Tulchiner, Nina Staudacher, Josef Fritz, Monika Hackl, Martin Pichler, Maximilian Seles, Shahrokh F Shariat, David D'Andrea, Kilian Gust, Walter Albrecht, Karl Grubmüller, Stephan Madersbacher, Sebastian Graf, Lukas Lusuardi, Herbert Augustin, Andreas Berger, Wolfgang Loidl, Wolfgang Horninger, Renate Pichler

Research output: Journal article (peer-reviewed)Journal article

4 Citations (Scopus)


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.

Original languageEnglish
Article number5377
Issue number21
Publication statusPublished - 01 Nov 2021


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