CHANGES IN THE INCIDENCE AND MORTALITY OF TESTICULAR CANCER IN SCOTLAND WITH PARTICULAR REFERENCE TO THE OUTCOME OF OLDER PATIENTS TREATED FOR NONSEMINOMATOUS GERM-CELL TUMORS

This paper describes the temporal pattern of germ cell testicular canc er in Scotland between 1960 and 1990. The effect of age on the prognos is of patients with non-seminomatous germ cell tumours (NSGCT) has bee n assessed by studying all patients presenting in the West of Scotland between 1975 and 1989. Between 1960 and 1990, the number of testicula r germ cell tumours registered has increased more than 2-fold; mortali ty rates have declined equally dramatically. Univariate and multivaria te analysis of the data obtained on 440 patients with NSGCT showed age was not a prognostic factor influencing survival. 52 were patients ov er 40 years at presentation; their 5 years survival was 71% compared w ith 79% in the younger patients (n = 388). This small survival differe nce is probably explained by the higher proportion of older patients t reated before 1980. Treatment for this older group should be approache d with the same curative intent as for younger patients and the same e xpectation of success.