Worldwide Distribution, Risk Factors, and Temporal Trends of Testicular Cancer Incidence and Mortality: A Global Analysis

Background:We examined the global disease burden and trends of testicular cancer incidence and mortality by age and country, and their associations with human development index (HDI), gross domestic product (GDP), lifestyle habits, and metabolic risk factors. Methods:We retrieved the Global Cancer Observatory (GLOBOCAN) database for the testicular cancer incidence and mortality in 2020; the WHO Global Health Observatory for prevalence of risk factors; the Cancer Incidence in Five Continents (CI5), WHO mortality database for trend analysis.We presented the testicular cancer incidence and mortality using age-standardised rates.We examined their associations with HDI, GDP, smoking, alcohol drinking, physical inactivity, overweight, obesity, and medical conditions including diabetes, hypertension, and hypercholesterolaemia by linear regression.We estimated the 10-year trend of incidence and mortality by joinpoint regression with average annual percent change (AAPCs) with 95% confidence intervals in different age groups.Results: There was a wide variation in the testicular cancer burden with the highest mortality found in low-income countries while the highest incidence was observed in high-income countries.We found a positive association for HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia with testicular cancer incidence, whilst a negative correlation was observed between GDP and its mortality.Globally, there was an overall increasing trend of testicular cancer for the last decade, particularly in younger males; the mortality trends of testicular cancer were relatively stable.Conclusions: There was a global variation in the testicular cancer burden associated with HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia.Testicular cancer had an increasing incidence but decreasing mortality.The increasing testicular cancer incidence in the younger population is worrying and calls for early detection and preventive interventions.