Armen Ghazarian, MPH, Cancer Research Training Award Fellow, National Cancer Institute
The incidence of testicular cancer, the most commonly occurring cancer among young men in the United States, has long been higher among white men than men of racial/ethnic groups. A National Cancer Institute study team used NAACCR Cancer in North America (CiNA) data to examine trends in testicular cancer incidence by race/ethnicity and by geographic area. We found that while testicular cancer incidence remains highest among white men, rates are increasing most rapidly among Hispanic men in all regions of the US, except the South. Reasons for the increase among Hispanics are unknown, but could possibly be related to place of birth, changing environmental exposures, genetic susceptibility or length of residence in the United States according to Armen Ghazarian, one of the authors of the study.
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Abstract
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. Cancer2015;121:4181–4189. © 2015 American Cancer Society.
The opinions expressed in this article are those of the authors and may not represent the official positions of NAACCR.