Abstract
BackgroundIn Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the EU average. We prospectively evaluated the effect of socioeconomic position on patient delay and therapy outcomes.MethodsQuestionnaires on subjective social status (MacArthur Subjective Status Scale), objective socioeconomic position (wealth, education, and housing data), and on patient’s delay were completed by newly diagnosed TGCC patients.ResultsPatients belonged to a relatively high socioeconomic class, a university degree was double the Hungarian average, Cancer-specific mortality in the highest social quartile was 1.56% while in the lowest social quartile 13.09% (p = 0.02). In terms of patient delay, 57.2% of deceased patients waited more than a year before seeking help, while this number for the surviving patients was 8.0% (p = 0.0000). Longer patient delay was associated with a more advanced stage in non-seminoma but not in seminoma, the correlation coefficient for non-seminoma was 0.321 (p < 0.001). For patient delay, the most important variables were the mother’s and patient’s education levels (r = − 0.21, p = 0.0003, and r = − 0.20, p = 0.0005), respectively. Since the patient delay was correlated with the social quartile and resulted in a more advanced stage in non-seminoma, the lower social quartile resulted in higher mortality in non-seminoma patients (p = 0.005) but not in seminoma patients (p = 0.36) where the patient delay was not associated with a more advanced stage.ConclusionsBased on our result, we conclude that to improve survival, we should promote testicular cancer awareness, especially among the most deprived populations, and their health care providers.
Highlights
In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the European Union (EU) average
Another factor of the slower progress may partly relate to differences in socioeconomic position (SEP), i.e., men with lower SEP may be characterized by a lack of awareness and may be less likely to seek immediate medical help, they tend to have the worst access to medical service, in remote and rural communities
Analyses were performed on 303 patients who met the inclusion criteria (3 cases with non-gonadal origin were excluded from the analysis)
Summary
In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the EU average. The slower and delayed declines in the less developed, lower resource countries imply that the high cost of appropriate treatments together with inadequate patient referral systems are responsible for the high mortality rates and less favourable trends. Another factor of the slower progress may partly relate to differences in socioeconomic position (SEP), i.e., men with lower SEP may be characterized by a lack of awareness and may be less likely to seek immediate medical help, they tend to have the worst access to medical service, in remote and rural communities. Since SSS is easier to measure the current study examined how SSS correlates with SEP indicators among Hungarian testicular cancer patients
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