Scrotal cancer in the West Midlands 1936-76.

Between 1936 and 1976, 344 cases of scrotal cancer were registered in the West Midlands Region. There was a considerable increase in the number of registrations after 1955, the figures remaining high until the 1970s since when they appear to be falling towards the low level seen in the early years of registration. By the end of December 1981 250 deaths had occurred. The cause of death was known in 226 cases and of these, 97 (42.9%) were attributed to cancer of the scrotum, 40 (17.7%) to other malignancies, and 89 (39.4%) to other causes, scrotal cancer not being mentioned on the death certificate. The mean age at registration was 59.3 years and at death 66 years. Mean survival was 6.6 years with a five year survival rate of 51%. Survival was shorter in men who presented with palpable lymph nodes and greater in those treated with surgery alone. Occupations were known for all but 28 of the cases and of these, 61.9% had been exposed to mineral oil and a further 7.8% to pitch and tar. Among the occupations with exposure to mineral oil, tool setters and tool fitters accounted for the greatest proportion, 89 men having followed those trades. In 74 cases second primary tumours were registered after the scrotal primary, mostly in the skin and bronchus. There was no relation between the development of second primary tumours and exposure to mineral oil or to pitch and tar.