Factors Associated With Testicular Cancer Risk Among New American Military Recruits During Wartime.

Testicular cancer (TCa) comprises the majority of peri/postpubertal male neoplasms and has increased in incidence. A review of the literature finds little information on short-term risks associated with mens' occupational choices. The U.S. Army includes a large population in the age range of highest TCa risk. We examined whether combat duty and occupational categories were associated with TCa in this population during a recent period of prevalent combat operations. We employed official medical, administrative and sociodemographic data on 210,483 males new to active-duty service in the U.S. Army during 2011-2014, when combat operations in Afghanistan continued apace and those in Iraq were waning. We calculated TCa diagnosis incidence rates by occupation and service time, compared predictor distributions, and devised a multivariable survival regression model. There were 44 new recruits diagnosed with TCa (period prevalence: 0.02%; incidence rate: 11.61 per 100,000 person-years). Within up to 4 years of service, the adjusted TCa diagnosis risk increased twofold for those in the infantry occupation when compared with other military occupations (