title: Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009.
abstract: OBJECTIVE
  Increasing in incidence, testicular cancer is the most commonly diagnosed cancer in young men in the USA and in Europe. We sought to determine contemporary trends in testicular cancer incidence in the USA and Europe.
  
  
  METHODS
  Testicular cancer incidence data covering the USA and Europe were extracted from the SEER-13 (SEER*Stat 8.0.1) and the EUREG databases, respectively. Trends were determined using JoinPoint 3.5.3.
  
  
  RESULTS
  Testicular germ cell tumor (TGCT) incidence among US males >15 years increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with a significant annual percentage change (APC: 1.1%, p < 0.001). Seminomas were 29% of all TGCTs in 15-26 year-olds, increasing to 78% in those 40+ years of age. TGCT rates were highest in White men (1992: 7.5/100,000; 2009: 8.6/100,000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among Asian (1992: 2.0/100,000; 2009: 2.8/100,000) and Black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in White men (APC: 1.2%, p < 0.001) and most prominently in Hispanic men, especially from 2002 to 2009 (APC: 5.6%, p < 0.01). Incidence of testicular cancer increased in 15 of 19 (79%) European countries analyzed (p < 0.05). Denmark (13.4/100,000 man-years), Switzerland (12.7/100,000 man-years), and Norway (12.7/100,000 man-years) exhibited the highest age-standardized rates, while Spain had the greatest APC (APC = 5.5, 95% CI 3.9-7.0%, p < 0.001).
  
  
  CONCLUSIONS
  Between 1992 and 2009, testicular cancer incidence in the USA and Europe continued to increase, most notably in US Hispanic, Northern European, Spanish, and younger and older populations.
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
authors.forename: Manas
authors.initials: M
authors.lastname: Nigam
authors.forename: Briseis
authors.initials: B
authors.lastname: Aschebrook-Kilfoy
authors.forename: Sergey
authors.initials: S
authors.lastname: Shikanov
authors.forename: Scott
authors.initials: S
authors.lastname: Eggener
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012042:Registries; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult