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. Material and 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. Conclusion: 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.

Keywords:
Testicular cancer, Mortality, Age-cohort-period analysis
1.
Levi F, La Vecchia C, Boyle P, Lucchini F, Negri E: Western and eastern European trends in testicular cancer mortality. Lancet 2001;357:1853-1854.
2.
Levi F, Lucchini F, Boyle P, Negri E, La Vecchia C: Testicular cancer mortality in Eastern Europe. Int J Cancer 2003;105:574.
3.
Hanna NH, Einhorn LH: Testicular cancer - discoveries and updates. N Engl J Med 2014;371:2005-2016.
4.
Woodward PJ, Mostofi FK, Talerman A, Heidenreich A, Hailemariam S, Kaplan GW, Looijenga LHJ, Parkinson MC, Ulbright TM, Oosterhuis JW, Grigor K, Sesterhenn IA, McLeod DG, True L, Rushton HG, Møller H, Jacobsen GK, Michael H, Manivel JC, Oliver TD, Reuter VE: Germ cell tumours; in Eble JN, Sauter G, Epstein JI, Sesterhenn IA (eds): Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs, ed 1. Lyon, International Agency for Research on Cancer (IARC) Press, 2004, pp 221-249.
5.
Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP: EAU guidelines on testicular cancer: 2011 update. Eur Urol 2011;60:304-319.
6.
Stang A, Rusner C, Eisinger B, Stegmaier C, Kaatsch P: Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries. Int J Androl 2009;32:306-316.
7.
Stang A, Katalinic A, Dieckmann KP, Pritzkuleit R, Stabenow R: A novel approach to estimate the German-wide incidence of testicular cancer. Cancer Epidemiol 2010;34:13-19.
8.
Schmidt CG, Seeber S: Chemotherapy of testicular neoplasms. Dtsch Med Wochenschr 1979;104:1488-1493.
9.
Hölzel D, Altwein JE: Hodentumoren. Ist der Rückgang der Mortalität in der Bundesrepublik Deutschland zu langsam erfolgt? Dtsch Arztebl 1991;88:A4123-A4130.
10.
Becker N, Boyle P: Decline in mortality from testicular cancer in West Germany after reunification. Lancet 1997;350:744.
11.
Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J: Cancer Incidence in Five Continents. Lyon, International Agency for Research on Cancer (IARC) Press, 1997.
12.
Rutherford MJ, Lambert PC, Thompson JR: Age-period-cohort modelling. Stata J 2010;10:606-627.
13.
Tumorzentrum Land Brandenburg: Qualitätsbericht 2010 - Qualitätssicherung durch klinische Krebsregister. Cottbus, 2011.
14.
Epidemiologisches Krebsregister NRW gGmbH: Report 2011 mit Datenbericht 2009. Münster, 2011.
15.
Epidemiologisches Krebsregister NRW gGmbH: Report 2012 mit Datenbericht 2010. Münster, 2012.
16.
Bevölkerungsbezogenes Krebsregister Bayern: Jahresbericht 2012 - Krebs in Bayern in den Jahren 2009 und 2010. Erlangen, 2013.
17.
Dieckmann KP, Becker T, Bauer HW: Testicular tumors: presentation and role of diagnostic delay. Urol Int 1987;42:241-247.
18.
Stang A, Jansen L, Trabert B, Rusner C, Eberle A, Katalinic A, Emrich K, Holleczek B, Brenner H; GEKID Cancer Survival Working Group: Survival after a diagnosis of testicular germ cell cancers in Germany and the United States, 2002-2006: a high resolution study by histology and age. Cancer Epidemiol 2013;37:492-497.
19.
Feuer EJ, Frey CM, Brawley OW, Nayfield SG, Cunningham JB, Geller NL, Bosl GJ, Kramer BS: After a treatment breakthrough: a comparison of trial and population-based data for advanced testicular cancer. J Clin Oncol 1994;12:368-377.
20.
Collette L, Sylvester RJ, Stenning SP, Fossa SD, Mead GM, de Wit R, de Mulder PH, Neymark N, Lallemand E, Kaye SB: Impact of the treating institution on survival of patients with ‘poor-prognosis' metastatic nonseminoma. European organization for research and treatment of cancer genito-urinary tract cancer collaborative group and the medical research council testicular cancer working party. J Natl Cancer Inst 1999;91:839-846.
21.
Suzumura S, Ioka A, Nakayama T, Tsukuma H, Oshima A, Ishikawa O: Hospital procedure volume and prognosis with respect to testicular cancer patients: a population-based study in Osaka, Japan. Cancer Sci 2008;99:2260-2263.
22.
Vlayen J, Vrijens F, Devriese S, Beirens K, Van Eycken E, Stordeur S: Quality indicators for testicular cancer: a population-based study. Eur J Cancer 2012;48:1133-1140.
23.
Thibault C, Fizazi K, Barrios D, Massard C, Albiges L, Baumert H, Patard JJ, Escudier B, Loriot Y: Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours. Eur J Cancer 2014;50:1284-1290.
24.
Weißbach L, Bamberg M, Schmoll HJ, et al: Interdisziplinäre Konsensus-konferenz zur ‘Diagnostik und Therapie von Hodentumoren'. Urologe 1997;173:397-406.
25.
Luy M: Selected aspects of mortality trends in Germany from 1950 to 2000. Z Bevölkerungswissenschaften 2004;29:3-62.
26.
Diehl K: Potential factors for the rapid reduction in Eastern German excess mortality after reunification. Z Bevölkerungswissenschaften 2008;33:89-110.
27.
McKee M, Nolte E: Lessons from health during the transition from communism. BMJ 2004;329:1428-1429.
28.
Vaupel JW, Carey JR, Christensen K: Aging. It's never too late. Science 2003;301:1679-1681.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.