Diagnosis, Treatment and Survival From Testicular Cancer: Real-World Data From the National Health Service England Between 2013 and 2020

Abstract

Introduction

The National Disease Registration Service (NDRS) collects and curates data on cancer diagnoses in England. This study analyzed testicular cancer (TC) data from 2013 to 2020.

Patient and Methods

Data were extracted from the NDRS “Get Data Out” database. The incidence per year, routes to diagnosis (RTD), treatment modalities and overall survival were analyzed.

Results

Between 2013 to 2020, 15,921 TC were diagnosed. The majority of cases were seminomatous germ cell tumors (SGCT) (61.4%), followed by nonseminomatous germ cell tumors (NSGCT) (33.6%). The annual incidence remained relatively stable, with 2010 cases in 2013 and 2023 cases in 2019. The majority of patients were ≥30 years (72.4%). Most cases (64%) were diagnosed with stage I disease, with a rising incidence observed in stage I NSGCTs. The primary RTD was the 2-week-wait (2ww) cancer pathway (59.1%), followed by GP referrals (15.7%) and emergency presentations (8.9%). A total of 90.4% of TC were treated with surgery, with or without chemotherapy, regardless of the histological subtype. Stage II-III disease more commonly underwent surgery combined with chemotherapy compared to stage I disease (65.7% vs. 46.8%, P < .0001). The 12, 24, and 60-month survival was 98.0%, 96.9%, and 95.6% respectively. Stage I disease and SGCT were associated with better survival outcomes (P < .001). Missing data from this dataset is a limitation.

Conclusion

The incidence of TC in England is relatively stable. Most TC were diagnosed via the 2ww cancer pathway. Surgery was the primary treatment modality and survival rates have remained relatively stable over time. Real-world data provide a cost-effective, time-efficient source of information to guide disease epidemiology, diagnostics, treatments, and outcomes.