MP12-01 SOCIOECONOMIC FACTORS IMPACT METASTATIC TESTICULAR CANCER INCIDENCE AND OUTCOMES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP12-01 SOCIOECONOMIC FACTORS IMPACT METASTATIC TESTICULAR CANCER INCIDENCE AND OUTCOMES Yash Shah, Hanan Goldberg, Brian Hu, Siamak Daneshmand, and Thenappan Chandrasekar Yash ShahYash Shah More articles by this author , Hanan GoldbergHanan Goldberg More articles by this author , Brian HuBrian Hu More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , and Thenappan ChandrasekarThenappan Chandrasekar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with metastatic testicular cancer (TC) experience poorer outcomes than those with localized disease. Social determinants of health (SDOH) may compound this trend. Using a population-based cohort, we aimed to elucidate social predictors of metastatic TC and study their prognostic implications. METHODS: Patients aged ≥18 with TC diagnosed from 2010-2016 were identified using the Surveillance, Epidemiology, and End Results database. A quartile-based, county-level socioeconomic status (SES) measure was developed using median household income and the percentage of individuals within the patient’s county meeting the following four criteria: sub-high school education, income below the poverty line, unemployment, and foreign-birth. Descriptive statistics were analyzed using Fisher’s exact test and Pearson chi-square test for continuous and categorical variables. Predictors of metastasis and cancer-specific mortality (CSM) were evaluated using multivariate logistic regression hazard analysis and competing risks regression, respectively. p<0.05 was considered significant. RESULTS: In total, 16,474 patients were included. 1,877 (11.39%) had distant metastases at diagnosis. Patients with metastases were more commonly Black or American Indian/Alaskan, single or separated, uninsured, and of lower SES (all p<0.001). Upon multivariable adjustment, predictors of metastatic disease at initial diagnosis included age, Southeastern U.S. residence, Hispanic ethnicity, American Indian/Alaskan race, single marital status, and lower SES. Predictors were further stratified by metastatic site. Insurance status did not predict metastasis incidence. One-fourth of patients with metastases died. CSM was worse in patients who were older (HR 1.04) or lacked insurance (HR 1.70), though it improved with higher SES (HR 0.55) or in those having a marital partner (HR 0.51). CSM was significantly worse in the Southeastern U.S. CONCLUSIONS: This contemporary series of 16,528 patients captured over 25% of U.S. TC diagnoses from 2010-2016, permitting a comprehensive analysis of epidemiologic and social trends impacting metastatic TC. These findings highlight the importance of SDOH and may inform novel public health strategies to improve outcomes. Source of Funding: AUA Summer Medical Student Fellowship: Herbert Brendler, MD Research Fund © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e133 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yash Shah More articles by this author Hanan Goldberg More articles by this author Brian Hu More articles by this author Siamak Daneshmand More articles by this author Thenappan Chandrasekar More articles by this author Expand All Advertisement PDF downloadLoading ...