Trends and an age-period-cohort analysis of testicular cancer incidence and mortality in China from 1990 to 2021

Background: The testicular cancer incidence rate in China has been rising since 1990, which has brought a huge burden to China, but its influencing factors are still under discussion. This study aims to investigate the trends of testicular cancer incidence and mortality in China from 1990 to 2021. Methods: The trends were estimated by the Estimated Annual Percentage Change model and Joinpoint regression analysis model using the data from GBD 2021, and the influence of age, period, and birth cohort on testicular cancer within the analysis model of age-period-cohort. Results: The age-standardized incidence rate (per 100,000) became 2.24 (95 % UI 2.16-2.35) in 2021 from 1.50 (95 % UI 1.45-1.55) in 1990; the age-standardized mortality rate (per 100,000) became 0.29 (95 % UI 0.27-0.30) in 2021 from 0.33(95 % UI 0.32-0.35) in 1990. The incidence and mortality in different age groups were different under the influence of various periods. The risk of incidence and mortality of testicular cancer peaks for the first time in young adulthood (around age 30-34) and starts to increase again from the age of 55-59; the incidence risk has shown a continuous upward trend, while the mortality risk has exhibited a fluctuating downward trend in period effects; the mortality risk has shown a decreasing trend, but the incidence risk among recent birth cohorts has been increasing in birth cohort effects. Conclusion: It is crucial to focus on cancer screening for both adolescents and older adults for testicular cancer, and pay more appropriate interventions to individuals born in recent years.