Mortality is higher when testicular cancer is diagnosed after age 40 years

Compared with younger patients, men who received a diagnosis of testicular cancer (TC) after age 40 years were twice as likely to die of the disease, according to the findings of a recent study.

Lois B. Travis, MD, ScD, of the Rubin Center for Cancer Survivorship at the University of Rochester (New York) Medical Center, and colleagues sought to better characterize the prognostic significance of age at diagnosis of testicular cancer, as well as socioeconomic status, race, and even marital status. “In a cancer that is so curable, it is important to identify any influence that confers an increased risk of TC-specific mortality,” they wrote in their report, published in Journal of Clinical Oncology.

By calculating hazard ratios based on 10-year TC-specific mortality data from 27,948 patients with testicular cancer reported to the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program (, the researchers learned of the increased risk of death among the older men. This risk held for both main types of disease: seminoma and nonseminoma. The analysis also revealed that unmarried men had twofold-to-threefold excess mortality compared with married men. Among men with nonseminoma TC, lower socioeconomic status and nonwhite race corresponded with a heightened risk of death.

Dr. Travis's group noted that many older patients with TC are not treated with the same intensity as younger men, one factor that could contribute to the difference in age-related mortality.
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