title: Socio-economic inequalities in testicular cancer survival within two clinical studies.
abstract: BACKGROUND
  Testicular cancer is the most common cancer in men under 35 years of age, and has the highest survival for adult male malignancies. Despite the fact that survival is very high, there is evidence that survival differs between socio-economic groups.
  
  
  METHODS
  We analysed survival patterns for 1606 testicular cancer patients diagnosed during 1984-2001 and recruited to one of two clinical studies. The first was a surveillance study to determine relapse-free survival after orchidectomy in 865 patients with stage I nonseminomatous germ-cell testicular cancer diagnosed during 1984-1991 (TE04). The second study was a trial in which 1174 men with stage I seminomatous germ-cell tumours were randomised to receive radiotherapy or one injection of carboplatin between 1996 and 2001 (TE19). The number of men available for analysis from these two studies was 578 and 1028, respectively. We followed these patients up for their vital status, and assigned them an ecological measure of deprivation. Crude and relative survival were estimated at 5 and 10 years by socio-economic deprivation.
  
  
  RESULTS
  No significant socio-economic gradient was seen: 1.3% (95% CI -0.3% to 3.1%) at 5 years and 2.1% (95% CI -0.5% to 4.7%) at 10 years.
  
  
  CONCLUSIONS
  We conclude that, given equal treatment at a given stage of disease, survival from testicular cancer does not depend on socio-economic status. This suggests that the socio-economic gradient in testicular cancer survival in the general population is more likely to be attributable to health care system factors than to personal or socio-economic factors in the men themselves.
authors: Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK. ula.nur@lshtm.ac.uk
authors: Ula
authors: U
authors: Nur
authors: Bernard
authors: B
authors: Rachet
authors: Mahesh K B
authors: MK
authors: Parmar
authors: Mathew R
authors: MR
authors: Sydes
authors: Nicola
authors: N
authors: Cooper
authors: Sally
authors: S
authors: Stenning
authors: Graham
authors: G
authors: Read
authors: Tim
authors: T
authors: Oliver
authors: Malcolm
authors: M
authors: Mason
authors: Michel P
authors: MP
authors: Coleman
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011878:Radiotherapy; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D013736:Testicular Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin