Factors Associated With Testicular Cancer Risk Among New American Military Recruits During Wartime

Area of Science:

• Oncology
• Occupational Health
• Military Medicine

Background:

• Testicular cancer (TCa) incidence is rising, particularly in peri/postpubertal males.
• Limited data exists on short-term occupational risks for male cancers.
• The U.S. Army represents a large population within the peak TCa risk age group.

Purpose of the Study:

• To investigate associations between combat duty, occupational categories, and TCa risk in U.S. Army personnel.
• To analyze TCa incidence within a specific cohort during a period of active combat operations.

Main Methods:

• Utilized medical, administrative, and sociodemographic data for 210,483 U.S. Army male recruits (2011-2014).
• Calculated TCa diagnosis incidence rates stratified by occupation and service duration.
• Employed multivariable survival regression to model TCa risk predictors.

Main Results:

• 44 new recruits were diagnosed with TCa (0.02% prevalence; 11.61 per 100,000 person-years).
• Infantry occupation was associated with a twofold increased adjusted TCa diagnosis risk (p = .045) within 4 years of service.
• TCa risk increased with age and White race, and decreased with service time; combat deployment showed no association.

Conclusions:

• Occupational variations in TCa risk were observed within 4 years of U.S. Army service entry.
• While selection effects are possible, causative occupational exposures cannot be excluded.
• Further research is needed to identify causal pathways and develop risk mitigation strategies for TCa.