Ethnic and socioeconomic trends in testicular cancer incidence in New Zealand.
Ethnic differences in testicular cancer incidence within countries are often sizeable, with white populations consistently having the highest ethnic-specific rates. Many studies have found that high socioeconomic status is a risk factor for testicular cancer. The objectives of this article are to test whether trends in testicular cancer incidence have varied by ethnicity and socioeconomic position in New Zealand between 1981 and 2004. Five cohorts of the entire New Zealand population for 1981-1986, 1986-1991, 1991-1996, 1996-2001 and 2001-2004 were created, and probabilistically linked to cancer registry records, allowing direct determination of ethnic and household income trends in testicular cancer incidence. There were more than 2,000 cases of testicular cancer over the study period. We found increasing rates of testicular cancer for all ethnic and income groups since 1990s. Maori had higher rates, and Pacific and Asian lower rates than European/other men with rate ratios pooled over time of 1.51 (95% CI 1.31-1.74), 0.40 (95% CI 0.26-0.61) and 0.54 (95% CI 0.31-0.94), respectively. Overall, men with low incomes had higher risk of testicular cancer than those with high incomes (pooled rate ratio for lowest to highest income groups = 1.23; 95% CI 1.05-1.44). There was no strong evidence that disparities in testicular cancer incidence have varied by ethnicity or household income over time. Given the lack of understanding of the etiology of testicular cancer, the unusual patterns identified in the New Zealand context may provide some etiological clues for future novel research.
Department of Public Health, University of Otago Wellington, Wellington, New Zealand. diana.sarfati@otago.ac.nz
Diana
D
Sarfati
Caroline
C
Shaw
Tony
T
Blakely
June
J
Atkinson
James
J
Stanley
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005006:Ethnicity; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology / Q000208:ethnology; D044382:Population Groups; D012042:Registries; D012306:Risk; D012923:Social Class; D013736:Testicular Neoplasms / Q000191:economics / Q000453:epidemiology*; D016896:Treatment Outcome