Predictors of Testicular Cancer Mortality in Brazil: A 20-Year Ecological Study

SIMPLE SUMMARY: The aim of this study is to investigate the factors that influence mortality and survival rates in testicular cancer in Brazil. The researchers examined sociodemographic and risk factors, as well as the influence of diagnostic and treatment procedures on reducing mortality. The study analyzed data from individuals who died of testicular cancer between 2001 and 2020. Results showed a progressive increase in mortality after 2011, particularly among individuals born after 1976 and aged 15 to 40 years. Certain regions, marital statuses, and racial affiliations were associated with higher mortality rates. The use of certain pesticides also affected mortality rates in different regions. Despite high rates of diagnostic procedures, they were not sufficient to reduce mortality. The study highlights the need for targeted interventions and improved treatment strategies to reduce testicular cancer mortality rates in Brazil. ABSTRACT: Testicular cancer is common in young men, and early detection and multimodality treatment can lead to successful outcomes. This study aims to identify sociodemographic and risk factors associated with higher testicular cancer mortality and poorer survival rates, while examining the impact of diagnostic and treatment procedures on reducing mortality. The retrospective ecological study analyzed mortality data from testicular cancer in Brazil from 2001 to 2020. Sociodemographic variables such as marital status, age, birth period, year of death (cohort), race, and geographic region were assessed. Risk factors included cryptorchidism and pesticide exposure. Data were subjected to statistical analysis, which revealed an increasing trend in mortality after 2011 among persons born after 1976 in the 15–40 age group. Individuals in the South Region, whites, and singles had higher age-standardized mortality rates (ASMRs), while singles had lower survival rates. The Northeast region had a higher survival rate. Fungicides and insecticides increase ASMR in Brazil. Herbicides increase ASMR in the Northeast and Midwest regions and insecticides increase ASMR in the Northeast, Southeast, and Midwest regions. High rates of implementation of diagnostic procedures in the Midwest were not sufficient to reduce ASMR. No treatment procedure was associated with mortality at the national or regional level.