To do this, the authors performed a nested case-control study including 6,250 patients with TGCC who were diagnosed between 1992-2014, individually matched to 62,500 controls. They used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between history of psychiatric diagnoses and TGCC risk.
Among patients with TGCC, the authors used a cohort study design and Cox regression to calculate hazard ratios (HRs) with 95% CIs of the association between psychiatric diagnosis and all-cause and TGCC-specific mortality.
In the case-control study design, for both patients with seminoma and those with non-seminoma, a history of cryptorchidism was more common among men with testis cancer.
The authors found that a history of a neurodevelopmental disorder (i.e., attention deficit hyperactivity disorder, autism spectrum disorder, and intellectual disabilities) was associated with an increased risk of seminoma (OR 1.54; 95% CI 1.09-2.19). Additionally, seminoma patients with neurodevelopmental disorders were younger (34 versus 38 years, p=0.004) and more often presented with stage IV disease (5.4% versus 1.2%, p=0.04) than those without such a history. Interestingly, patients with psychotic disorders were found to have a decreased risk of seminoma (OR 0.62; 95% CI 0.40-0.96). Taken overall, the authors found that psychiatric history overall was not associated with TGCC.
In spite of this, patients with a history of any psychiatric disorder had an increased all-cause mortality (HR 2.91; 95% CI 2.11-4.02) and an increased TGCC-specific mortality (HR 1.79; 95% CI 1.04-3.08). There was an increase in cause-specific mortality for both non-seminoma and seminoma among men with a history of psychiatric diagnoses.
Thus, Dr. Jansson concluded that this presentation represents the first identification of this novel association between neurodevelopmental disorders and testicular seminoma.
Presented by: Anna K. Jansson, PhD student at Department of Immunology, Genetics and Pathology, Cancer Precision Medicine; Research group Ingrid Glimelius, Uppsala, Sweden
Written by: Christopher J.D. Wallis, University of Toronto Twitter: @WallisCJD during the 2022 European Society for Medical Oncology (ESMO) Annual Congress, 9-13 September 2022.