title: Long-term health effects among testicular cancer survivors.
abstract: Testicular cancer is diagnosed at a young age and survival rates are high; thus, the long-term effects of cancer treatment need to be assessed. Our objectives are to estimate the incidence rates and determinants of late effects in testicular cancer survivors.
  
  
  
  We conducted a population-based cohort study of testicular cancer survivors, diagnosed 1991-2007, followed up for a median of 10 years. We identified 785 testicular cancer patients who survived ≥5 years and 3323 men free of cancer for the comparison group. Multivariate Cox regression analysis was used to compare the hazard ratio between the cases and the comparison group and for internal analysis among case patients.
  
  
  
  Testicular cancer survivors experienced a 24 % increase in risk of long-term health effects >5 years after diagnosis. The overall incidence rate of late effects among testicular cancer survivors was 66.3 per 1000 person years. Higher risks were observed among testicular cancer survivors for hypercholesterolemia, infertility, and orchitis. Chemotherapy and retroperitoneal lymph node dissection appeared to increase the risk of late effects. Being obese prior to cancer diagnosis appeared to be the strongest factor associated with late effects.
  
  
  
  Testicular cancer survivors were more likely to develop chronic health conditions when compared to cancer-free men.
  
  
  
  While the late effects risk was increased among testicular cancer survivors, the incidence rates of late effects after cancer diagnosis was fairly low.
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA. mia.hashibe@utah.edu.|Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA. mia.hashibe@utah.edu.
authors.forename: Mia
authors.initials: M
authors.lastname: Hashibe
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA.|Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Abdelaziz
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Temimi
authors.affiliation: Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Fraser
authors.affiliation: Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.|Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Boucher
authors.affiliation: Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Smith
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA.
authors.forename: Yuan-Chin Amy
authors.initials: YA
authors.lastname: Lee
authors.affiliation: Medical Informatics, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Rowe
authors.affiliation: Medical Informatics, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: Braden
authors.initials: B
authors.lastname: Rowley
authors.affiliation: University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors.forename: Micky
authors.initials: M
authors.lastname: Daurelle
authors.affiliation: Department of Communication, University of Utah, Salt Lake City, UT, USA.
authors.forename: Avery E
authors.initials: AE
authors.lastname: Holton
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA.
authors.forename: James
authors.initials: J
authors.lastname: VanDerslice
authors.affiliation: Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Richiardi
authors.affiliation: Intermountain Urological Institute, Salt Lake City, UT, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Bishoff
authors.affiliation: Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.|Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Will
authors.initials: W
authors.lastname: Lowrance
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Stroup
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012306:Risk; D015996:Survival Rate; D017741:Survivors; D013736:Testicular Neoplasms / Q000401:mortality; D055815:Young Adult
keywords: Cardiovascular disease; Late effects; Obesity; Testicular cancer