Incidence, mortality and survival of testicular germ cell cancer in the province of Tarragona (Spain), 1980-2018.

BACKGROUND: Testicular germ cell cancer (TGCC) is a rare malignancy whose incidence is increasing in many European countries. This study aimed to describe the trends in the incidence, mortality, and survival of TGCC and its morphological types (seminoma and non-seminoma) in the province of Tarragona (Spain) over the last four decades, using population-based data from the Tarragona Cancer Registry. METHODS: The study included all incident cases of TGCC diagnosed between 1980 and 2018 in the province of Tarragona. Descriptive and bivariate analyses were performed to examine the association between disease stage and the following variables: period of diagnosis, age, morphology, lactate dehydrogenase (LDH), beta-human chorionic gonadotropin (β-hCG), and alpha-fetoprotein (AFP). Incidence and mortality were assessed by calculating the mean annual number of cases, crude and age-adjusted rates, and the annual percentage change (APC) over the study period. Five- and 10 year survival rates were estimated for all tumors as a whole and stratified by stage, period of diagnosis, age, and morphology. RESULTS: A total of 458 cases of TGCC were identified, 55% of which were seminomas. The incidence increased significantly over time (APC = 4.3%; 95% CI 3.3-5.3), with the greatest increase observed in men aged 40-49 years. Most cancers were diagnosed at stage I. Mortality remained stable. Survival rates have improved, although not significantly, with 10 year net survival rates exceeding 90% in recent years. CONCLUSIONS: The incidence rates of TGCC have increased in Tarragona, in line with European trends, while survival rates have increased non-significantly, especially in the last decade, probably reflecting advances in treatment and early diagnosis.