Long-term health effects among testicular cancer survivors



Testicular cancer is diagnosed at a young age and survival rates are high; thus, the long-term effects of cancer treatment need to be assessed. Our objectives are to estimate the incidence rates and determinants of late effects in testicular cancer survivors.


We conducted a population-based cohort study of testicular cancer survivors, diagnosed 1991–2007, followed up for a median of 10 years. We identified 785 testicular cancer patients who survived ≥5 years and 3323 men free of cancer for the comparison group. Multivariate Cox regression analysis was used to compare the hazard ratio between the cases and the comparison group and for internal analysis among case patients.


Testicular cancer survivors experienced a 24 % increase in risk of long-term health effects >5 years after diagnosis. The overall incidence rate of late effects among testicular cancer survivors was 66.3 per 1000 person years. Higher risks were observed among testicular cancer survivors for hypercholesterolemia, infertility, and orchitis. Chemotherapy and retroperitoneal lymph node dissection appeared to increase the risk of late effects. Being obese prior to cancer diagnosis appeared to be the strongest factor associated with late effects.


Testicular cancer survivors were more likely to develop chronic health conditions when compared to cancer-free men.

Implications for Cancer Survivors

While the late effects risk was increased among testicular cancer survivors, the incidence rates of late effects after cancer diagnosis was fairly low.

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This work was supported by a grant from the National Cancer Institute at the National Institutes of Health (grant number R03 159357). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Partial support for all datasets within the Utah Population Database was provided by the University of Utah Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support grant, P30 CA2014 from the National Cancer Institute. Research was supported by the Utah Cancer Registry, which is funded by Contract No. HHSN261201000026C from the National Cancer Institute’s SEER Program with additional support from the Utah State Department of Health and the University of Utah.

Author information

Correspondence to Mia Hashibe.

Ethics declarations


This study was supported by a grant from the National Cancer Institute at the National Institutes of Health (grant number R03 159357).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The study used secondary data and did not involve any contact of participants. We obtained a waiver of consent for all individual participants included in the study with our IRB.

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Hashibe, M., Abdelaziz, S., Al-Temimi, M. et al. Long-term health effects among testicular cancer survivors. J Cancer Surviv 10, 1051–1057 (2016).

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  • Testicular cancer
  • Late effects
  • Cardiovascular disease
  • Obesity