Skip to main content

Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009



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.


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.


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).


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.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Curado MP, Edwards B, Shin HR et al (2007) Cancer incidence in five continents, vol IX. IARC, Lyon

    Google Scholar 

  2. 2.

    McKiernan JM, Goluboff ET, Liberson GL et al (1999) Rising risk of testicular cancer by birth cohort in the United States from 1973 to 1995. J Urol 162:361–363

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Stang A, Trabert B, Wentzensen N et al (2012) Gonadal and extragonadal germ cell tumours in the United States, 1973–2007. Int J Androl 35:616–625. doi:10.1111/j.1365-2605.2011.01245.x

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. 4.

    Bray F, Richiardi L, Ekbom A et al (2006) Trends in testicular cancer incidence and mortality in 22 European countries: continuing increases in incidence and declines in mortality. Int J Cancer J Int Cancer 118:3099–3111. doi:10.1002/ijc.21747

    Article  CAS  Google Scholar 

  5. 5.

    Shah MN, Devesa SS, Zhu K, McGlynn KA (2007) Trends in testicular germ cell tumours by ethnic group in the United States. Int J Androl 30:206–13; discussion 213–4. doi: 10.1111/j.1365-2605.2007.00795.x

  6. 6.

    Looijenga LH, Gillis AJ, Stoop H et al (2011) Dissecting the molecular pathways of (testicular) germ cell tumour pathogenesis; from initiation to treatment-resistance. Int J Androl 34:e234–e251. doi:10.1111/j.1365-2605.2011.01157.x

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Van de Geijn GJ, Hersmus R, Looijenga LH (2009) Recent developments in testicular germ cell tumor research. Birth Defects Res C Embryo Today Rev 87:96–113. doi:10.1002/bdrc.20140

    Article  Google Scholar 

  8. 8.

    Reuter VE (2005) Origins and molecular biology of testicular germ cell tumors. Mod Pathol Off J US Can Acad Pathol Inc 18(Suppl 2):S51–S60. doi:10.1038/modpathol.3800309

    CAS  Google Scholar 

  9. 9.

    National Cancer Institute D (2012) Surveillance, epidemiology, and end results (SEER) Program SEER*stat database: incidence-SEER 13 Regs Public-Use, Nov 2011 Sub (1973–2009)-linked to county attributes-total US., 1969–2010 Counties

  10. 10.

    JoinPoint Regression Program, Version 3.5-April 2011; Statistical methodology and applications branch and data modeling branch, surveillance research program national cancer institute

  11. 11.

    Znaor A, Lortet-Tieulent J, Jemal A, Bray F (2013) International variations and trends in testicular cancer incidence and mortality. Eur Urol. doi:10.1016/j.eururo.2013.11.004

    PubMed  Google Scholar 

  12. 12.

    Shanmugalingam T, Soultati A, Chowdhury S et al (2013) Global incidence and outcome of testicular cancer. Clin Epidemiol 5:417–427. doi:10.2147/CLEP.S34430

    PubMed Central  PubMed  Google Scholar 

  13. 13.

    Cook MB, Akre O, Forman D et al (2010) A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer–experiences of the son. Int J Epidemiol 39:1605–1618. doi:10.1093/ije/dyq120

    Article  PubMed Central  PubMed  Google Scholar 

  14. 14.

    Giwercman A, Giwercman YL (2011) Environmental factors and testicular function. Best Pract Res Endocrinol Metab 25:391–402. doi:10.1016/j.beem.2010.09.011

    Article  CAS  Google Scholar 

  15. 15.

    Swerdlow AJ, De Stavola BL, Swanwick MA, Maconochie NE (1997) Risks of breast and testicular cancers in young adult twins in England and wales: evidence on prenatal and genetic aetiology. Lancet 350:1723–1728

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Westergaard T, Olsen JH, Frisch M et al (1996) Cancer risk in fathers and brothers of testicular cancer patients in Denmark. a population-based study. Int J Cancer J Int Cancer 66:627–631

    Article  CAS  Google Scholar 

  17. 17.

    Gilbert D, Rapley E, Shipley J (2011) Testicular germ cell tumours: predisposition genes and the male germ cell niche. Nat Rev 11:278–288. doi:10.1038/nrc3021

    Article  CAS  Google Scholar 

  18. 18.

    Korkola JE, Houldsworth J, Bosl GJ, Chaganti RS (2009) Molecular events in germ cell tumours: linking chromosome-12 gain, acquisition of pluripotency and response to cisplatin. BJU Int 104:1334–1338. doi:10.1111/j.1464-410X.2009.08855.x

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Kanetsky PA, Mitra N, Vardhanabhuti S et al (2009) Common variation in KITLG and at 5q31.3 predisposes to testicular germ cell cancer. Nat Genet 41:811–815. doi:10.1038/ng.393

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. 20.

    Korkola JE, Houldsworth J, Feldman DR et al (2009) Identification and validation of a gene expression signature that predicts outcome in adult men with germ cell tumors. J Clin Oncol Off J Am Soc Clin Oncol 27:5240–5247. doi:10.1200/JCO.2008.20.0386

    Article  CAS  Google Scholar 

  21. 21.

    Krausz C, Looijenga LH (2008) Genetic aspects of testicular germ cell tumors. Cell Cycle Georget Tex 7:3519–3524

    Article  CAS  Google Scholar 

  22. 22.

    Weir HK, Marrett LD, Kreiger N et al (2000) Pre-natal and peri-natal exposures and risk of testicular germ-cell cancer. Int J Cancer J Int Cancer 87:438–443

    Article  CAS  Google Scholar 

  23. 23.

    Meeks JJ, Sheinfeld J, Eggener SE (2012) Environmental toxicology of testicular cancer. Urol Oncol 30:212–215. doi:10.1016/j.urolonc.2011.09.009

    Article  CAS  PubMed  Google Scholar 

  24. 24.

    Garner MJ, Birkett NJ, Johnson KC et al (2003) Dietary risk factors for testicular carcinoma. Int J Cancer J Int Cancer 106:934–941. doi:10.1002/ijc.11327

    Article  CAS  Google Scholar 

  25. 25.

    Lacson JC, Carroll JD, Tuazon E et al (2012) Population-based case-control study of recreational drug use and testis cancer risk confirms an association between marijuana use and non seminoma risk. Cancer. doi:10.1002/cncr.27554

    PubMed Central  Google Scholar 

  26. 26.

    McGlynn KA, Graubard BI, Klebanoff MA, Longnecker MP (2006) Risk factors for cryptorchism among populations at differing risks of testicular cancer. Int J Epidemiol 35:787–795. doi:10.1093/ije/dyl024

    Article  PubMed Central  PubMed  Google Scholar 

  27. 27.

    Pohl HG, Joyce GF, Wise M, Cilento BG (2007) Cryptorchidism and hypospadias. J Urol 177:1646–1651. doi:10.1016/j.juro.2007.01.058

    Article  PubMed  Google Scholar 

  28. 28.

    Bryc K, Velez C, Karafet T et al (2010) Colloquium paper: genome-wide patterns of population structure and admixture among Hispanic/Latino populations. Proc Natl Acad Sci USA 107(Suppl 2):8954–8961. doi:10.1073/pnas.0914618107

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. 29.

    Chia VM, Quraishi SM, Devesa SS et al (2010) International trends in the incidence of testicular cancer, 1973–2002. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 19:1151–1159. doi:10.1158/1055-9965.EPI-10-0031

    Article  Google Scholar 

  30. 30.

    McGlynn KA, Cook MB (2009) Etiologic factors in testicular germ-cell tumors. Future Oncol Lond Engl 5:1389–1402. doi:10.2217/fon.09.116

    Article  Google Scholar 

Download references


This research was supported by a training grant from the National Institute of Diabetes and Digestive and Kidney Diseases.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical standard

The manuscript does not contain clinical studies. Institutional review board exemption was acquired since no patient, physician, or hospital identifiers were examined in this study utilizing the Surveillance, Epidemiological, and End Results and EUREG databases.

Author information



Corresponding author

Correspondence to Scott Eggener.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nigam, M., Aschebrook-Kilfoy, B., Shikanov, S. et al. Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009. World J Urol 33, 623–631 (2015).

Download citation


  • Testis
  • Neoplasms
  • Germ cell and embryonal
  • Testicular neoplasms
  • Epidemiology