Toward the effective surveillance of hypospadias.
Concern about apparent increases in the prevalence of hypospadias--a congenital male reproductive-tract abnormality--in the 1960s to 1980s and the possible connection to increasing exposures to endocrine-disrupting chemicals have underlined the importance of effective surveillance of hypospadias prevalence in the population. We report here the prevalence of hypospadias from 1980 to 1999 in 20 regions of Europe with EUROCAT (European Surveillance of Congenital Anomalies) population-based congenital anomaly registers, 14 of which implemented a guideline to exclude glanular hypospadias. We also report data from the England and Wales National Congenital Anomaly System (NCAS). Our results do not suggest a continuation of rising trends of hypospadias prevalence in Europe. However, a survey of the registers and a special validation study conducted for the years 1994-1996 in nine EUROCAT registers as well as NCAS identified a clear need for a change in the guidelines for registration of hypospadias. We recommend that all hypospadias be included in surveillance, but that information from surgeons be obtained to verify location of the meatus, and whether surgery was performed, in order to interpret trends. Investing resources in repeated special surveys may be more cost-effective than continuous population surveillance. We conclude that it is doubtful whether we have had the systems in place worldwide for the effective surveillance of hypospadias in relation to exposure to potential endocrine-disrupting chemicals.
EUROCAT Central Registry, University of Ulster, Room 15E12, Newtownabbey, County Antrim, Northern Ireland BT37 0QB, UK. h.dolk@ulster.ac.uk
Helen
H
Dolk
Martine
M
Vrijheid
John E S
JE
Scott
Marie-Claude
MC
Addor
Bev
B
Botting
Catherine
C
de Vigan
Hermien
H
de Walle
Ester
E
Garne
Maria
M
Loane
Anna
A
Pierini
Sixto
S
Garcia-Minaur
Nigel
N
Physick
Romano
R
Tenconi
Awi
A
Wiesel
Elisa
E
Calzolari
David
D
Stone
D015986:Confounding Factors, Epidemiologic; D004703:Endocrine System / Q000187:drug effects*; D004785:Environmental Pollutants / Q000506:poisoning; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D017408:Guidelines as Topic; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology*; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D015203:Reproducibility of Results
D004785:Environmental Pollutants