title: Testicular-cancer survivors experience compromised language following chemotherapy: findings in a Swedish population-based study 3-26 years after treatment.
abstract: BACKGROUND
  Studies suggest an increased risk for compromised cognitive function among cancer survivors. It is unclear to what extent chemotherapy is the cause and how the dysfunction, when present, affects everyday life. The objective was to study self-reported behaviours that may depend on cognitive function, among testicular-cancer survivors who received various cycles of cisplatin-based chemotherapy by comparing them with those who did not.
  
  
  METHODS
  We identified 1173 eligible men diagnosed with non-seminomatous testicular cancer treated according to the national cancer-care programs SWENOTECA I-IV between 1981 and 2004. During an 18-month qualitative phase we constructed a study-specific questionnaire including questions about specific activities and behaviour in everyday life.
  
  
  RESULTS
  We obtained information from 960 of 1173 (82%) testicular-cancer survivors diagnosed on average 11 years previously. The prevalence of "saying similar but incorrect words" at least once a week was 5% among those having received no chemotherapy versus 16% among those having received five or more cycles, giving a prevalence ratio ("relative risk", RR) of 3.3 with a 95% confidence interval of 1.5 to 7.1. The corresponding figure for "saying words in the wrong order" was 3.1 (1.7-5.8), for "difficulties understanding what other people mean" 3.1 (1.3-7.7), for "saying words other than planned" 2.2 (1.1-4.5) and for "difficulties completing sentences" 2.0 (1.0-3.6). The relative risks for those with a low level of education ranged between 4.9 (1.6-14.9) and 15.3 (1.9-120.5).
  
  
  CONCLUSIONS
  Testicular-cancer survivors in Sweden who have received five or more cycles of cisplatin-based chemotherapy experience an increased incidence of long-term compromised language; the effect is primarily seen among men with a low level of education.
authors.affiliation: Clinical Cancer Epidemiology, Sahlgrenska Academy at University of Gothenburg, Sweden. johanna.skoogh@oncology.gu.se
authors.forename: Johanna
authors.initials: J
authors.lastname: Skoogh
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: Ulrika
authors.initials: U
authors.lastname: Stierner
authors.forename: Eva
authors.initials: E
authors.lastname: Cavallin-Ståhl
authors.forename: Ulrica
authors.initials: U
authors.lastname: Wilderäng
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Margaret
authors.initials: M
authors.lastname: Gatz
authors.forename: Boo
authors.initials: B
authors.lastname: Johansson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004522:Educational Status; D005500:Follow-Up Studies; D006801:Humans; D007806:Language Disorders / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D012306:Risk; D017741:Survivors; D013548:Sweden; D013736:Testicular Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002945:Cisplatin