Incidence of testicular germ cell tumors among US men by census region

BACKGROUNDThe incidence of testicular germ cell tumors (TGCTs) in the United States is notably higher among white men versus other men. Previously, however, it was reported that rates were rising among Hispanics in certain areas. To determine whether this finding was evident in a wider area of the United States, data from 39 US cancer registries were examined. METHODSRacial/ethnic-specific incidence rates per 100,000 man-years were calculated overall and by census region for the period of 1998-2011. Annual percentage changes (APCs) were estimated, and joinpoint models were fit. Differences in incidence by region were examined with the Wald test. RESULTSFrom 1998 to 2011, 88,993 TGCTs were recorded. The TGCT incidence was highest among non-Hispanic whites (6.57 per 100,000), who were followed by Hispanics (3.88), American Indians/Alaska Natives (2.88), Asians/Pacific Islanders (A/PIs; 1.60), and non-Hispanic blacks (1.20). The incidence significantly increased among Hispanics (APC, 2.31; P<.0001), with rates rising in all regions except the South. Rates rose slightly among non-Hispanic whites (APC, 0.51; P=.0076). Significant differences in rates by region were seen for Hispanics (P=.0001), non-Hispanic whites (P<.0001), and A/PIs (P<.0001), with the highest rates among Hispanics in the West and with the highest rates among non-Hispanic whites and A/PIs in the Northeast. CONCLUSIONSAlthough the incidence of TGCTs remained highest among non-Hispanic whites between 1998 and 2011, the greatest increase was experienced by Hispanics. Rising rates of TGCTs among Hispanics in the United States suggest that future attention is warranted. Reasons for the increase may include variability in birthplace, changing exposures, genetic susceptibility, and the length of US residence. Cancer 2015;121:4181-4189. (c) 2015 American Cancer Society. Between 1998 and 2011, although the incidence of testicular germ cell tumors in the United States remained highest among non-Hispanic white men, the greatest increase in incidence was experienced by Hispanic men. Significant differences in incidence rates by census region are observed for Hispanics, non-Hispanic whites, and Asian/Pacific Islanders, with the highest rates noted among Hispanics in the West and among non-Hispanic whites and Asian/Pacific Islanders in the Northeast.