Testicular Cancer Study of Adolescents and Young Adults Uncovers Socioeconomic Status and Race/Ethnicity Affect Survival

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Blacks, Hispanics and those living in lower socioeconomic neighborhoods had worst outcomes in Cancer Prevention Institute of California study.

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”The importance of this study is to show that some of the most striking inequities in cancer survival occur for cancers with relatively high survival potential.” said Mindy C. DeRouen, a research scientist at CPIC.

Testicular cancer is the most common cancer among adolescent and young adult men. In the most comprehensive study of testicular cancer survival to date, a group of researchers, led by Mindy C. DeRouen of the Cancer Prevention Institute of California, studied the association between race/ethnicity, neighborhood socioeconomic status and other clinical factors that are known to affect survival in adolescents and young adults.

Although the overall five-year survival rate following testicular cancer is 90%, the study found that survival was worse for blacks and Hispanics in comparison to whites and for those living in lower socioeconomic neighborhoods. The findings were published in November 2015 online ahead of print by the Journal of Adolescent and Young Adult Oncology.

Using the California Cancer Registry data, researchers obtained information for 14,249 patients between the ages of 15 – 39 diagnosed from 1988 to 2010.

Testicular cancer includes two main subtypes—seminoma and nonseminoma. Seminona is usually curable with surgery alone and rarely spreads to other parts of the body. The treatment for nonseminoma is more complicated as even small tumors frequently spread.

In this study, there was no racial/ethnic difference in overall survival in patients with seminoma. However, survival for blacks and Hispanics was lower for nonseminoma patients, independent of treatment and socioeconomic status.

Socioeconomic status affected outcomes for both types of testicular cancer. The survival rate was also lower for unmarried patients and those between the ages of 25 – 39 compared to 15 – 24.

The survival differences may reflect differences in chronic stress, discrimination, or lack of non-clinical support experienced by blacks, Hispanics, and men living in lower socioeconomic neighborhoods.

”The importance of this study is to show that some of the most striking inequities in cancer survival occur for cancers with relatively high survival potential.” said Mindy C. DeRouen, a research scientist at CPIC. “Treatment for testicular cancer is relatively well-defined and successful, but this paper shows that some patient groups have not benefitted equally from these medical advances. It is our hope that follow-up studies can further pinpoint how the patient experience differs for these groups.”

Other authors on this study are Mahasin Mujahid of the School of Public Health, University of California, Berkeley, Sandy Srinivas of the Department of Medicine/Oncology, Stanford University Medical Center, and Theresa H.M. Keegan in the Division of Hematology and Oncology at the University of California, Davis.

About the Cancer Prevention Institute of California
The Cancer Prevention Institute of California (CPIC) is the nation’s premier organization dedicated to preventing cancer and to reducing its burden where it cannot yet be prevented. CPIC tracks patterns of cancer throughout the entire population and identifies those at risk for developing cancer. Its research scientists are leaders in investigating the causes of cancer in large populations to advance the development of prevention-focused interventions. CPIC’s innovative cancer prevention research and education programs, together with the work of the Stanford Cancer Institute, deliver a comprehensive arsenal for defeating cancer. For more information, visit http://www.cpic.org.

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