Socio-economic inequalities in testicular cancer survival within two clinical studies.

Article English OPEN
Nur, U ; Rachet, B ; Parmar, MK ; Sydes, MR ; Cooper, N ; Stenning, S ; Read, G ; Oliver, T ; Mason, M ; Coleman, MP (2012)

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.<br/> 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.<br/> 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.<br/> CONCLUSION: 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.<br/>
  • References (20)
    20 references, page 1 of 2

    [1] Coleman MP, Rachet B, Woods LM et al. (2004) Trends and socioeconomic inequalities in cancer survival in England and Wales up to 2001. Br J Cancer 90: 1367-1373

    [2] Kogevinas M, Porta M (1997) Socioeconomic differences in cancer survival: a review of the evidence. In: Social inequalities and cancer. (IARC Scientific Publications No. 138). Kogevinas M, Pearce N, Susser M, Boffetta P (eds) pp 177-206. International Agency for Research on Cancer: Lyon

    [3] Coleman MP, Babb P, Mayer D, Quinn MJ, Sloggett A (1999) Cancer survival trends in England and Wales 1971-1995: deprivation and NHS region (CDROM). Office for National Statistics London, Office for National Statistics.

    [4] Nur U, Rachet B, Mitry E, Cooper N, Coleman MP (2008) Survival from testicular cancer in England and Wales up to 2001. Br J Cancer 99: S80-S82

    [5] Woods LM, Rachet B, Coleman MP (2006) Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol 17: 5-19

    [6] Read G, Stenning SP, Cullen MH et al. (1992) Medical-Research-Council Prospective-Study of Surveillance for Stage-I Testicular Teratoma. Journal of Clinical Oncology 10: 1762-1768

    [7] Oliver RTD, Mason MD, Mead GM et al. (2005) Radiotherapy versus singledose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 366: 293-300

    [8] Carstairs V (1995) Deprivation indices: their interpretation and use in relation to health. J Epidemiol Community Health 49: S3-S8

    [9] Woods LM, Rachet B, Coleman MP (2005) Choice of geographic unit influences socioeconomic inequalities in breast cancer survival. Br J Cancer 92: 1279-1282

    [10] Office of the Deputy Prime Minister (2004) The English Indices of deprivation 2004-summary (revised). http://www.communities.gov.uk/archived/publications/communities/indicesdepr ivation, accessed 21 Sep 2010

  • Metrics
    0
    views in OpenAIRE
    0
    views in local repository
    24
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    LSHTM Research Online - IRUS-UK 0 24
Share - Bookmark