Trends in testicular germ cell tumors among U.S. military servicemen, 1990-2003

Objective: To determine the incidence of testicular germ cell tumors among active duty males and compare it with the incidence in the general U.S. population. Methods: The Automated Cancer Tumor Registry and the Surveillance, Epidemiology, and End Results Program data from 1990 to 2003 were analyzed for men aged between 20 and 59 years by histology and stage at diagnosis. Rates were age adjusted using the male active duty military population as the standard. Results: Nonseminoma incidence was significantly lower in the military than in the general population (incidence rate ratio = 0.90, 95% confidence interval = 0.82-0.98). Trends in incidence tended to be similar in both the populations. Increases were observed for both histologic types but were only significant for seminoma (Automated Cancer Tumor Registry: 21% and Surveillance, Epidemiology, and End Results program: 16%; p < 0.05). Increases in incidence were only observed for localized tumors of both histologic types. Conclusions: The lower incidence of nonseminoma in the military and the increased incidence of localized tumors in both populations remain unexplained.