{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:41:53Z","timestamp":1787503313862,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Ricerca Corrente Annual Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>This study investigated the incidence, mortality, and 5-year survival rates of testicular cancers diagnosed in a northern Italian province, which were eventually associated with previous or subsequent extratesticular neoplasms. Cases from 1996 to 2020 were examined by age and histotype (seminoma vs. non-seminoma). The standardized incidence rate was calculated using the European population, and the annual percent change (APC) was reported. The five-year relative survival was estimated using the Pohar Perme method. The association with the second neoplasm was also evaluated. In our study, 385 patients with testicular cancer were included, most of whom were aged between 30 and 40 years. The non-seminoma and seminoma groups accounted for 44% and 18% of younger adults, respectively. The incidence rate increased during the study period (APC 1.6*); however, it increased in seminomas (APC 2.3*) but not in non-seminomas (APC \u22120.1). Conversely, the mortality rate remained constantly low either overall or in each of the two groups. The overall 5-year survival rate of testicular cancer patients was 95% (99% and 88% for seminomas and non-seminomas, respectively). Primary extratesticular tumors were documented in 37 cases, 18 after and 19 before the testicular cancer diagnosis. Our study confirms that the increased incidence and excellent survival rate are the prerogative of seminomas.<\/jats:p>","DOI":"10.3390\/biology12111409","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T03:42:08Z","timestamp":1699501328000},"page":"1409","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and Survival of Testicular Cancers in a Province in Northern Italy and Their Association with Second Tumors"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5089-5178","authenticated-orcid":false,"given":"Lucia","family":"Mangone","sequence":"first","affiliation":[{"name":"Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-456X","authenticated-orcid":false,"given":"Francesco","family":"Marinelli","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9225-781X","authenticated-orcid":false,"given":"Isabella","family":"Bisceglia","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Masini","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2299-5160","authenticated-orcid":false,"given":"Andrea","family":"Palicelli","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-7073","authenticated-orcid":false,"given":"Fortunato","family":"Morabito","sequence":"additional","affiliation":[{"name":"Biotechnology Research Unit, AO di Cosenza, 87100 Aprigliano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5156-7400","authenticated-orcid":false,"given":"Stefania","family":"Di Girolamo","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Neri","sequence":"additional","affiliation":[{"name":"Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3159-5268","authenticated-orcid":false,"given":"Carmine","family":"Pinto","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","unstructured":"Rajpert-De Meyts, E., Skakkebaek, N.E., and Toppari, J. (2018). Testicular Cancer Pathogenesis, Diagnosis and Endocrine Aspects, MDText.com, Inc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1038\/s41572-018-0029-0","article-title":"Testicular cancer","volume":"4","author":"Cheng","year":"2018","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S1470-2045(18)30903-3","article-title":"Risk of subsequent primary neoplasms in survivors of adolescent and young adult cancer (Teenage and Young Adult Cancer Survivor Study): A population-based, cohort study","volume":"20","author":"Bright","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_4","unstructured":"Eble, J.N., Sauter, G., Epstein, J.I., and Sesterhenn, I.A. (2004). World Health Organization: Classification of Tumours. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs, IARC Press."},{"key":"ref_5","unstructured":"(2023, September 20). Available online: https:\/\/www.cancer.org\/cancer\/testicular-cancer\/about\/key-statistics.html."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1038\/nrurol.2012.61","article-title":"Adolescent and adult risk factors for testicular cancer","volume":"9","author":"McGlynn","year":"2012","journal-title":"Nat. Rev. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Yazici, S., Del Biondo, D., Napodano, G., Grillo, M., Calace, F.P., Prezioso, D., Crocetto, F., and Barone, B. (2023). Risk Factors for Testicular Cancer: Environment, Genes and Infections-Is It All?. Medicina, 59.","DOI":"10.3390\/medicina59040724"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Li, Y., Lu, Q., Wang, Y., and Ma, S. (2020). Racial differences in testicular cancer in the United States: Descriptive epidemiology. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-06789-2"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Huang, S., Signal, V., Sarfati, D., Shaw, C., Stanley, J., McGlynn, K., and Gurney, J. (2018). Physical activity and risk of testicular cancer: A systemtic review. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4093-3"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"K\u00fcronya, Z., Fr\u00f6hlich, G., Lad\u00e1nyi, A., Martin, T., G\u00e9czi, L., Gyergyai, F., Horv\u00e1th, O., Kiszner, G., Kov\u00e1cs, \u00c1., and Dienes, T. (2021). Low socioeconomic position is a risk factor for delay to treatment and mortality of testicular cancer patients in Hungary, a prospective study. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11720-w"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e785","DOI":"10.1016\/j.clgc.2018.02.014","article-title":"Disparities in Access and Regionalization of Care in Testicular Cancer","volume":"16","author":"Macleod","year":"2018","journal-title":"Clin. Genitourin Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.canep.2011.07.008","article-title":"Socio-economic inequalities in testicular cancer survival within two clinical studies","volume":"36","author":"Nur","year":"2012","journal-title":"Cancer Epidemiol."},{"key":"ref_13","unstructured":"AIOM (2020). I Numeri del Cancro in Italia 2020, Intermedia Editore."},{"key":"ref_14","unstructured":"AIOM (2022). I Numeri del Cancro in Italia 2022, Intermedia Editore."},{"key":"ref_15","unstructured":"World Health Organisation (2013). International Classification of Diseases for Oncology, World Health Organisation. [3rd ed.]."},{"key":"ref_16","unstructured":"Mangone, L., Borciani, E., Michiara, M., Vicentini, M., Carrozzi, G., and Mancuso, P. (2015). I Tumori Nelle Province dell\u2019Area Vasta Emilia Nord: Piacenza, Parma, Reggio Emilia e Modena: Anni 2013\u20132014, Associazione Italiana Registri Tumori."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/1536867X1501500112","article-title":"Estimating and modeling relative survival","volume":"15","author":"Dickman","year":"2015","journal-title":"Stata J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer statistics, 2016","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J. Clin."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00345-014-1361-y","article-title":"Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009","volume":"33","author":"Nigam","year":"2015","journal-title":"World J. Urol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Schaffar, R., Pant, S., Bouchardy, C., Schubert, H., and Rapiti, E. (2019). Testicular cancer in Geneva, Switzerland, 1970\u20132012: Incidence trends, survival and risk of second cancer. BMC Urol., 19.","DOI":"10.1186\/s12894-019-0494-0"},{"key":"ref_21","unstructured":"Barber, N., and Ali, A. (2023, September 20). The Epidemiology of Testicular Cancer, Urologic Cancers, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK585983\/."},{"key":"ref_22","unstructured":"(2023, September 20). Available online: https:\/\/www.cancer.net\/cancer-types\/testicular-cancer\/statistics."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1093\/annonc\/mds460","article-title":"Testicular cancer in Europe and the USA: Survival still rising among older patients","volume":"24","author":"Verhoeven","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_24","first-page":"417","article-title":"Global incidence and outcome of testicular cancer","volume":"5","author":"Shanmugalingam","year":"2013","journal-title":"Clin. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1016\/j.ejca.2015.07.027","article-title":"EUROCARE-5 Working Group: Survival of male genital cancers (prostate, testis and penis) in Europe 1999\u20132007: Results from the EUROCARE-5 study","volume":"51","author":"Trama","year":"2015","journal-title":"Eur. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"342","DOI":"10.3109\/0284186X.2013.819992","article-title":"Markedly increased incidence and improved survival of testicular cancer in the Netherlands","volume":"53","author":"Verhoeven","year":"2014","journal-title":"Acta Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/ijc.32704","article-title":"Continuing increased risk of second cancer in long-term testicular cancer survivors after treatment in the cisplatin era","volume":"147","author":"Hellesnes","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1093\/jnci\/89.19.1429","article-title":"Risk of second malignant neoplasms among long-term survivors of testicular cancer","volume":"89","author":"Travis","year":"1997","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhang, L., Hemminki, O., Chen, T., Yu, H., Zheng, G., Chattopadhyay, S., F\u00f6rsti, A., Sundquist, K., Sundquist, J., and Hemminki, K. (2019). Second cancers and causes of death in patients with testicular cancer in Sweden. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214410"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1093\/jnci\/dji278","article-title":"Second cancers among 40,576 testicular cancer patients: Focus on long-term survivors","volume":"97","author":"Travis","year":"2005","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.urolonc.2015.05.002","article-title":"Secondary malignant neoplasms in testicular cancer survivors","volume":"33","author":"Curreri","year":"2015","journal-title":"Urol. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1093\/annonc\/mdu437","article-title":"Prognostic factors for relapse in stage I seminoma: A new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG)","volume":"25","author":"Aparicio","year":"2014","journal-title":"Ann Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3817","DOI":"10.1200\/JCO.2013.53.5831","article-title":"Surveillance for stage I nonseminoma testicular cancer: Outcomes and long-term follow-up in a population-based cohort","volume":"32","author":"Daugaard","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Kang, D.H., Cho, K.S., Jeong, J.Y., Moon, Y.J., Chung, D.Y., Jung, H.D., and Lee, J.Y. (2022). Surveillance versus Adjuvant Treatment with Chemotherapy or Radiotherapy for Stage I Seminoma: A Systematic Review and Meta-Analysis According to EAU COVID-19 Recommendations. Medicina, 58.","DOI":"10.3390\/medicina58111514"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.ucl.2015.05.002","article-title":"Long-term morbidity of testicular cancer treatment","volume":"42","author":"Fung","year":"2015","journal-title":"Urol. Clin. N. Am."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/11\/1409\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:19:46Z","timestamp":1760131186000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/11\/1409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["biology12111409"],"URL":"https:\/\/doi.org\/10.3390\/biology12111409","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]}}}