title: Global trends in testicular cancer incidence and mortality.
abstract: BACKGROUND
  Epidemiologic studies on testicular cancer have focused primarily on European countries. Global incidence and mortality have been less thoroughly evaluated.
  
  
  OBJECTIVE
  Our goal was to gain a better understanding of the most recent global age-standardized incidence and mortality rates for testicular cancer and to use these values to estimate a region's health care quality.
  
  
  METHODS
  Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for testicular cancer were obtained for men of all ages in 172 countries by using the GLOBOCAN 2008 database, reflecting the annual rate of cancer incidence and mortality per 100,000 men. These data were evaluated on a regional level to compare incidence and mortality rates. Global plots of these values were constructed to better visualize geographic distributions. Finally, the ratio of ASIR to ASMR was calculated as a method to assess each region's proficiency in diagnosing and effectively treating testicular cancer.
  
  
  METHODS
  ASIR and ASMR were analyzed by region, and each region's ratio of ASIR to ASMR was calculated.
  
  
  CONCLUSIONS
  Testicular cancer ASIR is highest in Western Europe (7.8%), Northern Europe (6.7%), and Australia (6.5%). Asia and Africa had the lowest incidence (<1.0%). ASMR was highest in Central America (0.7%), western Asia (0.6%), and Central and Eastern Europe (0.6%). Mortality was lowest in North America, Northern Europe, and Australia (0.1-0.2%). The ASIR-ASMR ratio was highest in Australia (65.0%) and lowest in western Africa (1.0%). National reporting systems varied by country, and data quality may have fluctuated between regions.
  
  
  CONCLUSIONS
  Testicular cancer incidence remains highest in developed nations with primarily Caucasian populations. Variable ASIR-ASMR ratios suggest markedly different geographic-specific reporting mechanisms, access to care, and treatment capabilities.
authors: Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA. alexandre.rosen@uchospitals.edu
authors: Alexandre
authors: A
authors: Rosen
authors: Gautam
authors: G
authors: Jayram
authors: Michael
authors: M
authors: Drazer
authors: Scott E
authors: SE
authors: Eggener