title: Mortality of Testicular Cancer in East and West Germany 20 Years after Reunification: A Gap Not Closed Yet.
abstract: BACKGROUND
  The decline of testicular cancer mortality in East Germany began in the 1980s, about 10 years later than that recorded in West Germany. We aimed at providing up-to-date time trends of testicular cancer mortality rates in Germany.
  
  
  METHODS
  Mortality data from East Germany (1971-2010) and West Germany (1954-2010) were provided by the Federal Bureau of Statistics. We estimated age-specific and age-standardized mortality rates using the World Standard Population.
  
  
  RESULTS
  Despite the declining trend in the 2000s, the mortality rates of testicular cancer remained higher in East than in West Germany. These rates were 5.5 and 2.6 per million person-years in 2010, respectively. Age-specific mortality trends by period and birth cohort showed that the mortality decline was larger among younger (15-44 years) than elderly men.
  
  
  CONCLUSIONS
  The mortality of testicular cancer is still higher in East than West Germany. Despite very similar densities of hospital beds, urologists and oncologist per million male population in both parts of Germany, we hypothesized that a paucity of centers of expertise for treating testicular cancers in the East could account for this particular pattern.
authors.affiliation: Institut fx00FC;r Medizinische Informatik, Biometrie und Epidemiologie, Universitx00E4;tsklinikum Essen, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Dieckmann
authors.forename: Joannie
authors.initials: J
authors.lastname: Lortet-Tieulent
authors.forename: Carsten
authors.initials: C
authors.lastname: Rusner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D005843:Geography; D005859:Germany, East / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult