title: Socioeconomic patterning in the incidence and survival of teenage and young adult men aged between 15 and 24 years diagnosed with non-seminoma testicular cancer in northern england.
abstract: OBJECTIVE
  Previous research from developed countries has shown a marked increase in the incidence of testicular cancer in the past 50 years. This has also been demonstrated in northern England, along with improving 5-year survival. The present study aims to determine if socioeconomic factors may play a role in both etiology and survival from non-seminoma testicular cancer.
  
  
  METHODS
  We extracted all 214 cases of non-seminoma testicular cancer diagnosed in teenage and young adult men aged between 15 and 24 years during 1968 to 2006 from the Northern Region Young Persons' Malignant Disease Registry, which is a population-based specialist regional registry. Negative binomial regression was used to examine the relationship between incidence and both the Townsend deprivation score (and component variables) and small-area population density. Cox regression was used to analyze the relationship between survival and both deprivation and population density.
  
  
  RESULTS
  Decreased incidence was associated with living in areas of higher household overcrowding for young adults aged between 20 and 24 years (relative risk per 1% increase in household overcrowding = 0.79; 95% CI: 0.66-0.94) but no association was detected for young people aged between 15 and 19 years. Community-level household unemployment was associated with worse survival (hazard ratio per 1% increase in household unemployment = 1.04; 95% CI: 1.00-1.08).
  
  
  CONCLUSIONS
  This study has shown that increased risk of non-seminoma testicular cancer in teenage and young adult men may be associated with some aspect of more advantaged living. In contrast, greater deprivation is linked with worse survival prospects. The study was ecological by design and so these area-based results may not necessarily apply to individuals.
authors: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK. Electronic address: Richard.McNally@ncl.ac.uk.
authors: Richard J Q
authors: RJ
authors: McNally
authors: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK.
authors: Nermine O
authors: NO
authors: Basta
authors: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK.
authors: Steven
authors: S
authors: Errington
authors: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK.
authors: Peter W
authors: PW
authors: James
authors: School of Geography, University of Leeds, Leeds, England, UK.
authors: Paul D
authors: PD
authors: Norman
authors: Northern Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, England, UK; Department of Paediatric Oncology, Great North Children's Hospital, Newcastle upon Tyne, England, UK.
authors: Juliet P
authors: JP
authors: Hale
authors: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK.
authors: Mark S
authors: MS
authors: Pearce
mesh_terms: D000293:Adolescent; D004739:England; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D012923:Social Class; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D055815:Young Adult
keywords: Epidemiology; Incidence; Socioeconomic factors; Survival; Testicular neoplasms