Analysis of the Increased Incidence of Aggressive Prostate Cancer After Prior Testicular Cancer.

Purpose: Men with a history of testicular cancer are known to have an increased risk of developing prostate cancer. The objective of this study is to determine if testicular cancer survivors are predisposed to a higher incidence of aggressive prostate cancer later in life and greater risks of mortality.

Materials and methods: The Surveillance, Epidemiology, and End Results database was searched for patients diagnosed with prostate cancer and either no prior cancer diagnosis or a previous diagnosis (≥ 5 years ago) of either testicular cancer or another cancer with a high survival rate (5-year survival > 70%). Cox regression models were used to determine the risk of mortality.

Results: Of the 392,238 prostate cancer patients, 423 had a history of testicular cancer, 31,428 had a history of another cancer, and 377,975 had no prior history of cancer. The mean ages of prostate cancer diagnosis were 62.53 +/- 8.23 years, 67.95 +/- 8.46 years, and 67.95 +/- 9.47, respectively (p < 0.001). Testicular cancer was associated with earlier mortality on survival analysis in multivariable analysis controlling for age of prostate cancer diagnosis, race, clinical T stage, PSA level at diagnosis, and Gleason score.

Conclusions: A history of testicular cancer may be associated with an increased risk of developing early prostate cancer and increased mortality. Confirmatory studies are warranted.