Global trends in testicular and prostate cancer among adolescents and young adult males aged 15-49 years, 1990-2021: insights from the GBD study.

Malignant reproductive system tumors significantly impact the physical and mental health of adolescent and young adult males (AYAMs, aged 15-49 years), particularly their fertility. In recent years, the incidence of testicular and prostate cancer in this population has risen, while early diagnosis and treatment remain challenging. However, global epidemiological data on AYAMs are limited. This study aims to evaluate global trends in the incidence and burden of testicular and prostate cancers among AYAMs from 1990 to 2021, using data from the Global Burden of Disease (GBD) 2021 study, to address the research gap and inform public health strategies. We extracted data on the incidence and disability-adjusted life years (DALYs) for testicular and prostate cancer in adolescents and young adult males (AYAMs) aged 15-49 years from the 2021 Global Burden of Disease (GBD) database, covering 204 countries and territories from 1990 to 2021. As the GBD 2021 database only includes data for testicular cancer (ICD-10 code C62) and prostate cancer (ICD-10 code C61), other male reproductive system cancers, such as penile and epididymal cancer, were excluded. To analyze temporal trends, we applied the estimated annual percentage change (EAPC) method using linear regression models to calculate age-standardized incidence and DALY rates. Additionally, Spearman's rank correlation was used to assess the relationship between age-standardized rates and the Socio-Demographic Index (SDI) for each country and region in 2021. In 2021, a total of 94,229 new cases of male reproductive system cancers were reported globally among AYAMs. From 1990 to 2021, the global age-standardized incidence rate significantly increased (EAPC = 1.38), while the age-standardized DALY rate exhibited a downward trend (EAPC = -0.26). Both testicular cancer and prostate cancer showed a consistent increase in age-standardized incidence rates, while their age-standardized DALY rates declined. Testicular cancer represented a significantly higher proportion of male reproductive system cancers in AYAMs globally compared to prostate cancer, with regional variations in the cancer burden. Additionally, the age-standardized incidence rates of both testicular and prostate cancers were positively correlated with the SDI, while the age-standardized DALY rate displayed a hill-shaped relationship with SDI. Over the past three decades, the incidence of testicular and prostate cancers among adolescents and young adult males (AYAMs) has steadily increased, accompanied by significant regional disparities in DALYs. To reduce the global burden of these cancers, particularly for AYAMs, targeted prevention strategies are crucial. These should include early screening, timely treatment, and public health education tailored to the unique needs of young males. In low- and middle-income countries, efforts should focus on improving health management, promoting physical activity, fostering healthy dietary habits, and enhancing access to early cancer screening for AYAMs. Early detection and intervention are essential for improving survival rates and minimizing the long-term effects of cancer, such as fertility issues and psychological impacts. Collaboration between governments, public health organizations, and social institutions is critical for advancing cancer prevention and control, with a focus on the specific health needs of AYAMs.