The aim of this study was to analyze trends in testicular cancer incidence, mortality, and survival in Latvia from 1994 to 2017.

This retrospective cohort study analyzed testicular cancer patients diagnosed in Latvia between 1994 and 2017. The population-based cancer registry recorded nearly all cases. Patients were categorized by age, tumor histology (seminoma, non-seminoma, unspecified), and disease stage according to the TNM classification system.

The Joinpoint regression model was used to analyze trends in incidence, mortality. Kaplan-Meier analysis was performed to calculate 5- and 10-year cancer-specific and overall survival probabilities.

During the study period, the age-standardized incidence rate of testicular cancer increased from 2.25 to 3.57 per 100,000, with an annual percentage change (APC) of 2.37% (95% CI: 0.78, 3.9).

The incidence of both seminoma and non-seminoma increased significantly. The APC for seminoma was 3.186% (95% CI: 0.429, 5.991), while for non-seminoma, it was 4.104% (95% CI: 0.486, 52.597).

The overall and cancer-specific 5-year survival probabilities in Latvia were 70.6% (95% CI: 67, 74) and 76.4% (95% CI: 73.4, 79.6), respectively. The overall and cancer-specific 10-year survival probabilities were 66% (95% CI: 62, 69) and 74.0% (95% CI: 70.8, 77.4), respectively.

The 5-year overall survival rate increased by 19.8 percentage points, from 59.1% in 1994-1999 to 80.9% in 2010-2017. The observed 5-year cancer-specific survival increased by 27.4 percentage points over the same period.

The mortality rate did not change significantly, with an APC of 1.32% (95% CI: -1.52 to 4.2) during this period.

A moderate increase in testicular cancer incidence was observed in Latvia over 23 years, while the mortality rate remained stable. The 5-year relative survival improved over different time periods; yet outcomes could be further enhanced if a multidisciplinary approach to diagnostics and management had been implemented in Latvia, as in other countries.