PD34-03 THE INCIDENCE AND TREATMENT OF HYPOGONADISM IN PATIENTS WITH TESTICULAR CANCER

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2016PD34-03 THE INCIDENCE AND TREATMENT OF HYPOGONADISM IN PATIENTS WITH TESTICULAR CANCER Jamal Nabhani, Diana Jin, and Siamak Daneshmand Jamal NabhaniJamal Nabhani More articles by this author , Diana JinDiana Jin More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.988AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Though the diagnosis of testicular cancer (TC) has been associated with hypogonadism, the mechanistic and clinical interrelation remains unclear. The fraction of men with TC who are on androgen replacement therapy (ART) has not been previously quantified. We investigate the pattern of diagnosis and treatment of hypogonadism in men with TC. METHODS Using Humana administrative claims data from 2007-2013, men with and without a diagnosis of TC were identified. Testosterone laboratory and prescription data were analyzed between the cohorts and by decade of life in order to adjust for differences in the rates of hypogonadism with age. RESULTS 2,647 men with and 6,337,475 without TC were identified, yielding a rate of 4.2 cases of TC per 100,000 men, peaking at 11.6 per 100,000 men in the fourth decade of life. 428 men with testis cancer (16.2%) had a serum testosterone checked. The odds ratio (OR) of having a serum testosterone level measured in patients with TC was 4.5 95% CI [4.0,5.0]. This increased with age, peaking with an 8.2 fold increase in the ninth decade of life. 211 of the 428 men with TC who had a serum testosterone measured (8.0% of all men with testis cancer) were found to have a low serum testosterone. The OR of having a low testosterone was 4.0 95% CI [3.5,4.6] in men with TC compared to controls, peaking at 6.1 in the eighth decade of life. The diagnosis of low serum testosterone predated TC diagnosis by > 30 days in 144 men (5.4% of all TC cases). In terms of ART 225 men (8.5%) with TC were prescribed testosterone. The OR of receiving a prescription was 4.5 95% CI [4.2,5.5] times higher than in men without TC and disproportionately high in younger men, with an 8.1 fold increase in the third decade of life. CONCLUSIONS Men with a diagnosis of TC are four times more likely to have a serum testosterone checked, be diagnosed with hypogonadism, and receive ART. Serum testosterone is measured and more frequently found to be low in elderly patients with a history of TC compared to age-matched controls. Additionally, hypogonadism often predates the diagnosis of testis cancer. Finally, despite higher detection in elderly patients, ART is prescribed more often to young men with TC. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e839-e840 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jamal Nabhani More articles by this author Diana Jin More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...