Racial/ethnic differences in trends of testicular germ cell tumor incidence in the United States, 1992-2021

Testicular germ cell tumors (TGCTs) are the most common cancers among young men in the United States. Incidence rates among non-Hispanic White (NHW) men historically have been much higher than the rates among other men. To study whether this pattern had changed, the authors examined trends in TGCT incidence for the years 1992-2021.

By using the Surveillance, Epidemiology, and End Results 12 registries database, age-standardized incidence rates per 100,000 person-years and 95% confidence intervals (CIs) were calculated overall and by histologic type (seminoma and nonseminoma), age, stage at diagnosis, and race/ethnicity. Trends in 5-year survival also were examined.

The age-standardized incidence rate of TGCT per 100,000 person-years increased from 4.71 (95% CI, 4.39-5.05) in 1992 to 6.22 (95% CI, 5.88-6.58) in 2021. The rates increased for both seminoma (average annual percent change [AAPC], 0.57%; 95% CI, 0.40%-0.75%) and nonseminoma (AAPC, 1.41%; 95% CI, 1.17%-1.64%) and among all race/ethnic groups, although the rates stabilized among NHW men. Increases in incidence were greatest among Hispanic men (AAPC, 3.03%; 95% CI, 2.66%-3.40%), who had one of the youngest median ages at diagnosis and were more likely to be diagnosed at advanced stages compared with NHW men. Seminoma and nonseminoma rates among Hispanic men converged over the study period, whereas seminoma rates remained higher among most other groups.

Hispanic men now have the highest TGCT incidence rates in the United States, although the rates increased among all groups between 1992 and 2021. Racial/ethnic differences in rates require further investigation.