Regional trends in testicular cancer burden among adolescents and young adults (15–39 years), 1990–2023: A Global Burden of Disease analysis.

5030 Background: Testicular cancer is the most common solid malignancy in adolescent and young adult (AYA) males. Contemporary long-term regional trends in incidence and health loss among AYAs remain incompletely described. We quantified trends in testicular cancer burden among ages 15–39 years from 1990–2023 across World Health Organization (WHO) regions. Methods: Using annual Global Burden of Disease (GBD) estimates (1990–2023) for ages 15–39 years, we assessed trends in incidence, prevalence, deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). For each WHO region and measure, we fit log-linear models (ln[rate] = β×year) and calculated annual average percent change (AAPC) as 100×(e^β−1), with 95% confidence intervals (CI) derived from the regression. Results: Incidence showed an upward trend in all regions, ranging from 0.62%/year in the African Region (95% CI 0.28–0.96) to 3.15%/year in the Eastern Mediterranean Region (2.98–3.33). Prevalence rose across regions, highest in the South-East Asia Region (6.04%/year, 5.82–6.26) and Eastern Mediterranean Region (5.22%/year, 5.09–5.34). Mortality trends varied across regions. Deaths declined in the Western Pacific (−1.69%/year, −1.99 to −1.39), Europe (−1.43%/year, −1.49 to −1.36), and Africa (−0.89%/year, −1.20 to −0.58), were stable in South-East Asia (−0.07%/year, p=0.44), and increased in the Americas (1.68%/year, 1.49–1.87) and Eastern Mediterranean (0.42%/year, 0.32–0.51). DALYs and YLLs followed similar patterns (declining in Europe/Western Pacific, rising in the Americas). Conclusions: From 1990–2023, testicular cancer incidence and survivorship-related burden increased across all WHO regions among AYAs, while mortality-related metrics improved in Europe/Western Pacific but worsened in the Americas and Eastern Mediterranean. These findings support urgent investigation of drivers of rising incidence and targeted strategies to reduce regional inequities in timely diagnosis and curative treatment for AYAs.