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Testicular cancer in men with cystic fibrosis

Published:February 24, 2022DOI:https://doi.org/10.1016/j.jcf.2022.02.008
      We read with interest the paper by Archangelidi et al. [
      • Archangelidi O.
      • Cullinan P.
      • Simmonds N.J.
      • Mentzakis E.
      • Peckham D.
      • Bilton D.
      • Carr S.B.
      Incidence and risk factors of cancer in individuals with cystic fibrosis in the UK; a case-control study.
      ]. who reported on the incidence and risk factors for cancer in individuals with cystic fibrosis (CF) in the United Kingdom. Using a case-control approach, they observed a high incidence of lower gastrointestinal cancers, confirming and extending results from a large cohort study in the United States [
      • Maisonneuve P.
      • Marshall B.C.
      • Knapp E.A.
      • Lowenfels A.B.
      Cancer risk in cystic fibrosis: a 20-year nationwide study from the United States.
      ]. Besides, they reported testicular cancer in six men with CF during the 19 years of observation. Although the authors did not mention whether this number was greater than in the control group or than expected based on cancer rates in the general population, it is consistent with a two-fold excess risk based on numbers and rates observed in the US cohort (Table 1).
      Table 1Observed and expected numbers of testicular cancers and standardized incidence ratios (SIRs) among cystic fibrosis patients in the United Kingdom and in the United States.
      Reference Registry Period Individuals Testicular cancers Expected number SIR (95% CI)
      Maisonneuve et al.
      • Maisonneuve P.
      • Marshall B.C.
      • Knapp E.A.
      • Lowenfels A.B.
      Cancer risk in cystic fibrosis: a 20-year nationwide study from the United States.
      CFF Patient Registry,

      USA
      1990–2009 41,188 16 9.3 1.7 (1.0–2.7)
      Archangelidi et al.
      • Archangelidi O.
      • Cullinan P.
      • Simmonds N.J.
      • Mentzakis E.
      • Peckham D.
      • Bilton D.
      • Carr S.B.
      Incidence and risk factors of cancer in individuals with cystic fibrosis in the UK; a case-control study.
      CF registry,

      UK
      1999–2017 12,886 6 2.8
      Number of expected cases in the UK registry extrapolated from the expected number in the US report corrected for the size and the duration of follow-up of the 2 cohorts = 9.3×19years20years×12,886patients41,188patients. The 95% confidence intervals were calculated assuming that the observed cases of cancer followed a Poisson distribution.
      2.2 (0.9–4.5)
      low asterisk Number of expected cases in the UK registry extrapolated from the expected number in the US report corrected for the size and the duration of follow-up of the 2 cohorts =  9.3 × 19 years 20 years × 12 , 886 patients 41 , 188 patients . The 95% confidence intervals were calculated assuming that the observed cases of cancer followed a Poisson distribution.
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