Racial differences among boys with testicular germ cell tumors in the United States

There are marked racial differences in the incidence of testicular germ cell tumors among United States men, with whites having 5 times the incidence of blacks and 3 times that of Asians. Testicular germ cell tumors in boys are rare, and limited racial classification by cancer registries has made attempts to discern racial patterns difficult. We hypothesize that recent diversification of race data by cancer registries may allow for more accurate racial classification, and that there are racial differences in the incidence of testicular germ cell tumors in prepubertal boys.

We identified all cases of histologically confirmed testicular germ cell cancer in boys 0 to 14 years old between 1992 and 2004 through the Surveillance, Epidemiology and End Results Program. We performed subgroup analysis in boys 0 to 9 years old. Race was categorized as white, black, American Indian/Alaska Native or Asian/Pacific Islander. Variables analyzed included age, tumor histology and year of diagnosis.

A total of 695 cases of testicular germ cell tumors were diagnosed among boys of all races, with an overall incidence of 6.3 per 1 million person-years. Testicular germ cell tumors were 1.4-fold more likely to develop in Asian/Pacific Islanders compared to whites (RR 1.4, 95% CI 1.1 to 1.8). Increased rates among Asian/Pacific Islanders were constant across all age strata, in cases of yolk sac tumor/embryonal, teratoma and seminoma, and were maintained from 1992 to 2004.

Asian/Pacific Islander boys are more likely to have testicular germ cell tumors compared to whites. Similar to adults, race appears to have a significant role in the incidence of testicular germ cell tumors among prepubertal boys.