Trends and projections of global testicular cancer burden from 1990 to 2035

Testicular cancer (TC) is the most common malignancy in young men, with incidence increasing globally, especially in high-income countries. Although survival has improved due to advances in diagnosis and treatment, disparities in TC burden remain. This study analyzes global, regional, and national trends in TC incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021, and projects future trends to 2035.

Data were obtained from the Global Burden of Disease (GBD) 2021 database. Incidence, mortality, and DALY rates per 100,000 population were calculated with 95% uncertainty intervals (UIs). Trend analysis used Joinpoint regression and estimated annual percentage change (EAPC). Decomposition analysis identified drivers of burden changes. A Bayesian age-period-cohort (BAPC) model projected future burden.

In 2021, there were 91,507 TC cases, 11,388 deaths, and 560,921 DALYs globally. From 1990 to 2021, cases rose by 136%, deaths by 49%, and DALYs by 44%. Incidence increased from 1.45 to 2.31 per 100,000. The middle socio-demographic index (SDI) region showed the highest EAPCs for incidence (4.34%), mortality (1.07%), and DALYs (0.92%). The Caribbean had the fastest-growing incidence (EAPC = 5.71%). Nationally, the U.S. had the most cases (11,845), Monaco the highest incidence (32.89/100,000), and Qatar the steepest rise (EAPC = 10.25%). By 2035, incidence is projected to rise further, while mortality and DALY rates may decline.

The global burden of TC has increased markedly since 1990, especially in middle-SDI regions and the Caribbean. Although some areas have seen improvements, rising incidence highlights the need for targeted prevention and optimized care strategies.