PD5-02 THE IMPACT OF LACK OF INSURANCE ON TESTICULAR CANCER PROGNOSIS IN YOUNG PATIENTS IN THE UNITED STATES. DATA FROM THE SEER DATA BASE

Abstract

You have accessJournal of UrologyPenis/Testis: Benign & Malignant Disease I1 Apr 2014PD5-02 THE IMPACT OF LACK OF INSURANCE ON TESTICULAR CANCER PROGNOSIS IN YOUNG PATIENTS IN THE UNITED STATES. DATA FROM THE SEER DATA BASE Mohamed Kamel, Mohammed Elfaramawi, Supriya Jadhav, and Rodney Davis Mohamed KamelMohamed Kamel More articles by this author , Mohammed ElfaramawiMohammed Elfaramawi More articles by this author , Supriya JadhavSupriya Jadhav More articles by this author , and Rodney DavisRodney Davis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.405AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Young adults have the highest risk of testicular cancer and more likely to be uninsured in the United States. The objective of this study was to explore the relationship between lack of insurance and testicular cancer prognosis and mortality. The Surveillance, Epidemiology, End Results (SEER) data base of the National Cancer Institute (NCI) was utilized for this study. METHODS Insurance details are included in the SEER database since 2007. Between 2007 and 2011, 5986 patients with testicular cancer in the age group 20-49 years were included in the SEER database. Of these patients 3415 (57.04%) were diagnosed with Seminoma (S) and 2571 (42.96%) with Non Seminoma germ cell tumor (NS). Cancer Specific Survival (CSS), metastasis at diagnosis (M+) and radiation therapy were compared between the uninsured (UI) and insured (I) populations. The SEER database does not include information on adjuvant chemotherapy. RESULTS Overall, 2.64% of (UI) vs. 1.36% of (I) died from testicular cancer (p=0.025) and 16.73% of (UI) vs.10.52% of (I) had (M+) at diagnosis (p<0.0001). In the Seminoma group, 4.19% of (UI) vs. 2.79% of (I) died from testicular cancer (p=0.326) and 25.92% of (UI) vs. 18.46% of (I) had (M+) at diagnosis (p=0.0007). Also, 3.14% of (UI) vs. 1.6% of (I) received adjuvant radiation therapy (p=0.037). In the Non Seminoma group, 1.06% of (UI) vs. 0.33% of (I) died from testicular cancer (p=0.020) and 7.43% of (UI) vs. 4.81% of (I) had (M+) at diagnosis (p=0.029). Also 2.12% of (UI) vs. 2.17% of (I) had retroperitoneal lymph node dissection (p=0.949). CONCLUSIONS Uninsured testicular cancer patients present with more advanced cancer stages and higher mortality than the insured patients. Uninsured Seminoma patients were more likely to receive adjuvant radiation therapy indicating more advanced cancer stage at diagnosis. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e90 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Mohamed Kamel More articles by this author Mohammed Elfaramawi More articles by this author Supriya Jadhav More articles by this author Rodney Davis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...