Paediatric testicular cancer: an updated review of incidence and conditional survival from the Surveillance, Epidemiology and End Results database.

OBJECTIVES: To determine, using the Surveillance, Epidemiology, and End Results (SEER) population-based database, the epidemiological variables and update the understanding of testicular tumours in children, as knowledge of their incidence and survival is predicated upon multi-institutional cooperation. PATIENTS AND METHODS: Using the SEER database, we ascertained the incidence rate, 5-year survival by disease stage at diagnosis, and 5-year conditional survival after surviving for 1-3 years for cases recorded between 1973 and 2005. We stratified the incidence rate by race and histology to examine if these factors affect disease characteristics.
RESULTS: We identified 195 cases of testicular tumours in children from birth to age 14 years, and 785 for children aged 15-18 years. Yolk sac tumour was the most common testicular tumour, and overall, Caucasian children were most at risk and four times more likely to be affected than African-American children. The incidence rate of testicular tumour overall has not increased significantly since 1973. Conditional survival is excellent for all testicular malignancies, with a 1-year conditional survival (chance of surviving 5-years after having survived the first year) of 99.6%.
CONCLUSIONS: We present an updated analysis of the SEER database for the incidence and survival of testicular tumours, and revisit the issue of whether the incidence of testicular tumours in children is increasing. We also present to our knowledge, the first calculation of conditional survival in children for this malignancy. There has been no significant increase in the incidence of testicular tumours for children aged <14 years. By contrast, the postpubertal group aged 15-18 years showed a reversal in this trend.