This article explains testicular cancer, its prevalence, and who is most likely to be affected. It also explores the causes and risk factors of testicular cancer and survival rates in the United States.
Testicular Cancer Overview
Testicular cancer is a group of cancers that originate in different cells of the testicles (the reproductive organs that produce sperm). There are two main types:
Germ cell tumors: These are the most common type. They originate in reproductive cells known as germ cells. Germ cells in the testicles give rise to sperm. Stromal cell tumors: These are a less common type. They originate in supportive tissues surrounding germ cells.
One of the common signs of testicular cancer is a painless lump or swelling in a testicle. There may also be a dull ache in the lower abdomen or groin. People often describe a feeling of heaviness in the scrotum (the sack of skin that houses the testicles) and an abnormal firmness of the testicle itself.
Testicular cancer does not commonly metastasize (spread to other organs and tissue), except for the lungs. Even if this were to occur, most people respond well to treatment. This usually involves the surgical removal of the testicle accompanied by radiation or chemotherapy—and live for many years after.
How Common Is Testicular Cancer?
Testicular cancer is relatively rare, accounting for less than 0.5% of cancers in males. In the United States, it is the 24th most common cancer by order of new diagnoses. An estimated 9,910 new cases occurred in 2022, according to the National Cancer Institute (NCI).
The risk of testicular cancer is highest in North America and Europe and lowest in Africa and Asia. For reasons that are not entirely clear, the number of new cases has been steadily rising in the United States since the 1990s.
Even so, people with testicular cancer are living longer than ever due to the remarkable effectiveness of treatments. In 2019, the NCI estimated that 283,792 people were living with testicular cancer in the United States.
Testicular Cancer by Race/Ethnicity
People of color are often disproportionately affected by cancer in the United States. This is not entirely the case with testicular cancer.
With testicular cancer, White people are at greater risk due in part to the role that genetics plays in the disease. Relative to other cancers, testicular cancer is remarkably hereditary, wherein White people have a greater predisposition for the disease than those who are Black, Latinx, or Asian.
According to a 2020 study published in the journal BMC Cancer:
White males in the United States are 34% more likely to get testicular cancer than Latinx males. White males are nearly 3 times more likely to get testicular cancer than Asian males. White males are nearly 6 times more likely to get testicular cancer than Black males.
Although White Americans have a higher rate of diagnosis, people of color are at greater risk of death from testicular cancer. According to the same study in BMC Cancer, people of color have lower survival rates and are more likely to have advanced testicular cancer than their White counterparts.
This is due in large part to unequal access to healthcare in the United States. This factor places people of color at greater risk of delayed diagnosis and treatment for all cancers.
Testicular Cancer by Age and Gender
Testicular cancer is limited to people born with testicles, which are part of the male reproductive system. People of any gender identity who have testicles can develop testicular cancer. Transgender women who have not undergone an orchiectomy (the surgical removal of the testicles) have the same risk of testicular cancer as anyone else with testicles.
Testicular cancer is different from other cancers affecting males in that it tends to occur at a younger age.
The average age at the time of diagnosis is around 33 years old. By contrast, less than 6% of cases occur in people under age 20, while only around 8% occur in people over age 55.
Causes and Risk Factors
Genetics plays a central role in a person’s risk of testicular cancer. Research shows that having a parent with testicular cancer increases your risk of the disease by nearly 400%, while having a sibling with the disease increases the risk by more than 800%.
But, other factors beyond family genetics can increase your risk, including:
Being between the ages of 20 and 34 Having an undescended testicle (known as cryptorchidism) Having had testicular cancer before Having human immunodeficiency virus (HIV)
Testicular cancer is more often diagnosed in White people than in those who are Black, Latinx, or Asian.
What Are the Mortality Rates for Testicular Cancer?
Testicular cancer is one of the most treatable forms of cancer. Because of this, the lifetime risk of dying from the disease is low: only around 1 in 5,000 males.
In fact, it was estimated that in 2022, there would be only 220 deaths reported among people with testicular cancer in the United States.
Overall, the five-year survival rate for testicular cancer is 95%, meaning that 95 out of every 100 people treated will be alive for at least five years following their diagnosis. Many will exceed this figure.
With that said, an early diagnosis almost invariably leads to better outcomes. For those whose cancer has not spread beyond the testicle, the five-year survival rate is 99%. By contrast, those whose cancer has spread to distant organs have a five-year survival rate closer to 73%.
That is not to say that all people have the same likelihood of survival. Studies have shown that the average five-year survival rate for Black males with testicular cancer is 88.8%.
Screening and Early Detection
There is no screening test for the early detection of testicular cancer. Most often, testicular cancer is found by chance when a person either touches their testicle, say in the shower, or does a self-exam. Sometimes, a healthcare provider will find a tumor during a routine physical.
There are no studies evaluating whether a testicular self-exam can reduce the risk of death from the disease. Most experts, including those at the NCI, believe that it probably wouldn’t. This is because testicular cancer is highly curable, even in the advanced stages.
For its part, the U.S. Preventive Services Task Force advises against the use of a testicular self-exam, citing that the “benefits of screening for testicular cancer are small to none.”
Summary
Testicular cancer is a rare and highly treatable form of cancer. Each year, around 9,000 new cases are diagnosed in the United States. Even when diagnosed in the advanced stages, most people treated for the disease will live for many years.
The lifetime risk of death from testicular cancer is also extremely low, hovering at around one in 5,000 males.
Factors that lead to a higher rate of testicular cancer include being a person with testicles between 20 and 34, having an undescended testicle, having a family history of testicular cancer, and having HIV. Testicular cancer is more often diagnosed in White Americans.
A Word From Verywell
Being diagnosed with testicular cancer can be alarming. Although the disease is highly treatable, the prospect of losing a testicle and undergoing radiation or chemotherapy can cause distress and anxiety.
Don’t let these feelings go unspoken or allow others to minimize those feelings. Speak with your healthcare provider and ask if there are online or in-person support groups you can contact.
By speaking with others who have gone through treatment and recovery, you can get a better handle on what to expect and come to terms with your diagnosis more positively and productively.
