MP01-04 GEOGRAPHICAL DISTRIBUTION OF TESTICULAR CANCER IN FINLAND SUGGESTS IN UTERO EXPOSURES AS UNDERLYING CAUSES BEHIND THE INCREASED INCIDENCE

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You have accessJournal of UrologyPenile & Testicular Cancer I (MP01)1 May 2024MP01-04 GEOGRAPHICAL DISTRIBUTION OF TESTICULAR CANCER IN FINLAND SUGGESTS IN UTERO EXPOSURES AS UNDERLYING CAUSES BEHIND THE INCREASED INCIDENCE Antti J. Kaipia, Karri Seppä, Elli Hirvonen, Nea Malila, Janne Pitkäniemi, Jorma Toppari, Peter J. Boström, and Heikki Seikkula Antti J. KaipiaAntti J. Kaipia , Karri SeppäKarri Seppä , Elli HirvonenElli Hirvonen , Nea MalilaNea Malila , Janne PitkäniemiJanne Pitkäniemi , Jorma ToppariJorma Toppari , Peter J. BoströmPeter J. Boström , and Heikki SeikkulaHeikki Seikkula View All Author Informationhttps://doi.org/10.1097/01.JU.0001008660.87408.90.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: During the recent decades, the incidence of testicular cancer (TC) has increased in the developed countries. The underlying causes for this trend are not known, but in utero exposures have been postulated to trigger events that eventually lead to TC. Since the 1990s, the semen quality has progressively declined in Finland (Rodprasert et al., 2019) and the trend has been most pronounced in the Southwest. During the same period, the incidence of TC has increased ca. 2.5-fold in Finland. We hypothesized that if the same environmental factors are responsible for both findings, analysis of TC patients' mothers' place of residence during pregnancy might give us insight on the potential role of environmental factors behind TC. METHODS: Men born in Finland in 1960-1999 were followed up for TC from birth to 42 years of age: 2542 cases among 1,342,996 men. Cumulative incidence by municipality was modelled using hierarchical Bayesian binomial regression. The model included the effects of 5-year birth cohorts and both spatially structured and unstructured random effects to describe variation across municipalities. RESULTS: Cumulative incidence (per 100,000 men) increased in all municipalities and ranged from 85 to 201 in 1960-1969, and 209 to 314 in 1970-1979. In all cohorts, it was the largest in men born in the Southwest: hospital districts of Varsinais-Suomi (143 95% CI [114-183] in 1960-1969, 291 [249-348] in 1970-1979), Helsinki (166 [128-210], 295 [250-350]) and Åland (182 [103-351], 302 [203-442]). CONCLUSIONS: Current evidence indicates that TC develops from germ cell neoplasia in situ that arises during embryogenesis. Maternal environmental exposures are thus likely to play a role in the TC pathogenesis. Environmental factors, especially exposure to estrogen-mimicking and antiandrogenic compounds, have been postulated as risk factors for TC. As direct evidence from cohort studies linking exposure to specific compounds to later development of TC is lacking, analysis such as the one herein provides strong support for the hypothesis of environmental factors during pregnancy as causative factors in the pathogenesis of TC. Download PPT Source of Funding: Competetive state funding for Tampere university hospital, Finnish cancer foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e2 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Antti J. Kaipia More articles by this author Karri Seppä More articles by this author Elli Hirvonen More articles by this author Nea Malila More articles by this author Janne Pitkäniemi More articles by this author Jorma Toppari More articles by this author Peter J. Boström More articles by this author Heikki Seikkula More articles by this author Expand All Advertisement PDF downloadLoading ...

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