title: Testicular cancer in Europe and the USA: survival still rising among older patients.
abstract: BACKGROUND
  Despite high curability, some testicular cancer (TC) patient groups may have increased mortality. We provide a detailed age- and histology-specific comparison of population-based relative survival of TC patients in Europe and the USA. Design Using data from 12 European cancer registries and the USA Surveillance, Epidemiology and End Results 9 database, we report survival trends for patients diagnosed with testicular seminomas and nonseminomas between 1993-1997 and 2003-2007. Additionally, a model-based analysis was used to compare survival trends and relative excess risk (RER) of death between Europe and the USA adjusting for differences in age and histology.
  
  
  RESULTS
  In 2003-2007, the 5-year relative survival of patients with testicular seminoma was at least 98% among those aged <50 years, survival of patients with nonseminoma remained 3%-6% units lower. Despite improvements in the relative survival of nonseminoma patients aged ≥ 50 years by 13%-18% units, survival remained markedly lower than the survival of seminoma patients of the same age. Model-based analyses showed increased RERs for nonseminomas, older, and European patients.
  
  
  CONCLUSIONS
  There remains little room for survival improvement among testicular seminoma patients, especially for those aged <50 years. Older TC patients remain at increased risk of death, which seems mainly attributable to the lower survival among the nonseminoma patients.
authors.affiliation: Eindhoven Cancer Registry / Comprehensive Cancer Centre South, Eindhoven, The Netherlands. Electronic address: research@ikz.nl.
authors.forename: R H A
authors.initials: RHA
authors.lastname: Verhoeven
authors.affiliation: German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Gondos
authors.affiliation: Eindhoven Cancer Registry / Comprehensive Cancer Centre South, Eindhoven, The Netherlands; Viecuri Medical Centre, Department of Clinical Epidemiology, Venlo, The Netherlands.
authors.forename: M L G
authors.initials: MLG
authors.lastname: Janssen-Heijnen
authors.affiliation: German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany.
authors.forename: K U
authors.initials: KU
authors.lastname: Saum
authors.affiliation: Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK.
authors.forename: D H
authors.initials: DH
authors.lastname: Brewster
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Institute for Cancer Study and Prevention, ISPO, Clinical and Descriptive Epidemiology Unit, Florence.
authors.forename: E
authors.initials: E
authors.lastname: Crocetti
authors.affiliation: Piedmont Cancer Registry, CPO - Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rosso
authors.affiliation: Finnish Cancer Registry, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Hakulinen
authors.affiliation: National Institute for Health Development, Department of Epidemiology and Biostatistics, Tallinn, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Aareleid
authors.affiliation: German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D018239:Seminoma / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D055815:Young Adult