Reasons behind the Delayed Diagnosis of Testicular Cancer: A Retrospective Analysis

Abstract

The aim of the present study was to identify the reasons behind the delayed diagnosis of testicular cancer in a group of Polish males diagnosed with this malignancy in 2015–2016. The study included data from 72 patients aged between 18 and 69 years. Based on the median time elapsed to the testicular cancer diagnosis, the study patients were divided into the timely diagnosis group (diagnosis within 10 weeks from initial manifestation, n = 40) and the delayed diagnosis group (diagnosis > 10 weeks from initial manifestation, n = 32). Diagnosis of testicular cancer > 10 weeks after its initial manifestation was associated with less favorable survival (5-year overall survival: 78.1% [95% CI: 59.5–88.9%] vs. 92.5% [95% CI: 78.5–97.5%], p = 0.087). Multivariate logistic regression analysis identified two independent predictors of the delayed diagnosis, age > 33 years (OR = 6.65, p = 0.020) and residence in the countryside (OR = 7.21, p = 0.012), with another two parameters, the lack of a regular intimate partner (OR = 3.32, p = 0.098) and the feeling of shame (OR = 8.13, p = 0.056), being at the verge of statistical significance. All the factors mentioned above should be considered during planning social campaigns aimed at the early detection of testicular malignancies, along with improving the quality and trustfulness of Internet-based information resources.

No Survival Differences among Germ-Cell Cancer Patients from Urban and Rural Areas

“…Due to the lack of adequate epidemiological data, we cannot exclude the possibility that patients who had not been referred had better, the same, or more unfavorable presentations or treatment outcomes irrespective of residential area. In addition, we cannot generalize our results to other centers, other sites in Switzerland or other European countries [2]. To allow a full appreciation of the impact of residential address on presentation and treatment outcome in GCC, comprehensive national registry data such as in Denmark would be required.…”

“…Germ-cell cancer (GCC) is curable in the majority of men. However, historical as well as recent data point to differences between patients coming from urban as compared to rural areas with more advanced presentations and inferior outcomes in the latter [1, 2]. Since the initial report, access to care has improved through better access to medical information as well as improved awareness of GCC in young men.…”

Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

“…Despite an unclear pathogenesis, early diagnosis of testicular cancer could improve cure rates and reduce the chance of metastasis [19]. Delayed diagnosis (>10 weeks) could result in a reduction in survival rate [20] and double the treatment cost, comparing that at advanced and early stages [21]. In addition, both a diagnosis (identifying tumor from non-tumor) and differential diagnosis (classifying benign and malignant) of testicular cancer are equally important to facilitate the selection of appropriate treatment.…”