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


METHODS
Racial/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.


RESULTS
From 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.


CONCLUSIONS
Although 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.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Armen A
AA
Ghazarian
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Britton
B
Trabert
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Barry I
BI
Graubard
Epidemiology Program, Public Health Science Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington.
Stephen M
SM
Schwartz
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Sean F
SF
Altekruse
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Katherine A
KA
McGlynn
D019352:Censuses; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology* / Q000208:ethnology*; D012044:Regression Analysis; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000208:ethnology*; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data
North American Association of Central Cancer Registries (NAACCR); ethnic groups; incidence; testicular cancer; testicular germ cell tumor (TGCT); trends