scholarly journals Low socioeconomic position is a risk factor for delay to treatment and mortality of testicular cancer patients in Hungary, a prospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zsófia Küronya ◽  
Georgina Fröhlich ◽  
Andrea Ladányi ◽  
Tamás Martin ◽  
Lajos Géczi ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Health Care Providers ◽  
Socioeconomic Position ◽  
Cell Cancer ◽  
Patient Delay ◽  
Advanced Stage ◽  
Care Providers ◽  
Cancer Awareness ◽  
Testicular Germ Cell ◽  
Education Levels

Abstract Background In 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. Methods Questionnaires 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. Results Patients 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. Conclusions Based 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.

scholarly journals Low Socioeconomic Status is a Risk Factor for Delay to Treatment and Mortality of Testicular Cancer Patients in Hungary. A Prospective Study

2021 ◽  
Author(s):  
Zsófia Küronya ◽  
Georgina Fröhlich ◽  
Andrea Ladányi ◽  
Tamás Martin ◽  
Lajos Géczi ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Testicular Cancer ◽  
Health Care Providers ◽  
Low Socioeconomic Status ◽  
Cell Cancer ◽  
Patient Delay ◽  
Advanced Stage ◽  
Care Providers ◽  
Cancer Awareness ◽  
Testicular Germ Cell

Abstract Background. In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 7.6% which is significantly higher than the EU average. We prospectively evaluated the effect of socioeconomic status on patient delay, doctor’s delay, and therapy outcomes.Methods: Questionnaires on subjective (MacArthur Subjective Status Scale), objective (wealth, education, and housing data) social status, and on patient’s and doctors’ delays were completed by newly diagnosed TGCC patients.Results: Patients 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.Conclusions: Based 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.

Testicular tumours

2011 ◽  
pp. 1418-1426
Author(s):  
Olof Ståhl ◽  
Jakob Eberhard ◽  
Aleksander Giwercman
Keyword(s):  
Testicular Cancer ◽  
Germ Cell ◽  
Semen Quality ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
High Risk Group ◽  
Point Of View ◽  
Testicular Function ◽  
Testicular Germ Cell ◽  
Sperm Dna Damage

Testicular cancer and the problems of male hypogonadism and infertility are closely related to each other—from a clinical as well as a biological point of view. Thus, men previously treated for testicular cancer are more and more frequently seen among patients referred to infertility clinics. This is due to the fact that: ◆ the survival rate among young testicular cancer patients is very high, being close to 95%, and the quality of life—including gonadal function—plays an important role in the men who have been cured ◆ there is an increasing knowledge that testicular function—both spermatogenesis and androgen production—in men with germ cell cancer is severely impaired. Recent research indicates a common prenatal cause of these pathologies of reproductive system ◆ modern techniques of assisted reproduction, particularly intracytoplasmic sperm injection (ICSI), have made it possible to obtain fertilization even when using ejaculates of extremely poor quality. This option has improved the possibility of cancer treated men becoming fathers. However, a source of potential worry is possible sperm DNA damage related to cancer and its treatment ◆ testicular germ cell cancer is more common in men presenting with poor semen quality. Thus, when investigating a man for infertility he should be assessed as to whether he belongs to a high-risk group for which a proper screening procedure should be offered (see below) Apart from this clinical link between testicular cancer and male infertility, there are also some indications of common biological factors involved in aetiology and pathogenesis. In this chapter some basic biological aspects of testicular cancer will be described. In Chapter 9.5.1 the hypothesis linking a rise of gonadal malignancy and poor testicular function is explained in more detail.

Health Care Providers’ Perspectives on Patient Delay for Seeking Care for Symptoms of Acute Myocardial Infarction

1999 ◽  
Vol 26 (5) ◽  
pp. 714-733 ◽  
Author(s):  
Jane Zapka ◽  
Barbara Estabrook ◽  
Janice Gilliland ◽  
Laura Leviton ◽  
Hendrika Meischke ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Health Care ◽  
Acute Myocardial Infarction ◽  
Health Care Providers ◽  
Patient Delay ◽  
Care Providers

Late relapse of testicular cancer.

1995 ◽  
Vol 13 (5) ◽  
pp. 1170-1176 ◽  
Author(s):  
J Baniel ◽  
R S Foster ◽  
R Gonin ◽  
J E Messemer ◽  
J P Donohue ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Germ Cell ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
Stage I ◽  
Late Relapse ◽  
Testicular Germ Cell ◽  
Testicular Germ Cell Cancer ◽  
Disease Free

PURPOSE This study analyzed a large group of patients with testicular germ cell cancer in complete remission, who relapsed more than 2 years after completion of treatment. PATIENTS AND METHODS A review of all patients treated at Indiana University Medical Center from 1979 through 1992 for late relapse was conducted. Eighty-one patients were treated for late relapse of testicular cancer. Forty-seven patients relapsed more than 5 years after successful management of their initial disease. RESULTS At initial diagnosis, 35 patients had clinical stage I, 18 stage II, and 28 stage III disease. Twenty-three of 35 stage I, all 18 stage II, and all 28 stage III patients were treated by chemotherapy before their late relapse. The median follow-up duration of patients post-management of late relapse was 4.8 years. Twenty-one patients (25.9%) are continuously disease-free. Nineteen of these 21 patients had surgical resection of carcinoma or teratoma as a component of their therapy. Of sixty-five patients treated for late relapse by chemotherapy, 17 (26.2%) had a complete response, but only two have been continuously disease-free with chemotherapy alone. These two never received prior chemotherapy. CONCLUSION Late relapse of testis cancer is more common than previously thought. Surgery is the preferred mode of therapy. Chemotherapy has only modest success in this entity, in contrast to the excellent results in de novo germ cell tumors. Patients treated for testicular germ cell cancer need annual follow-up evaluations throughout their life due to the possibility of late relapse.

scholarly journals Prognostic factors for relapse in patients with clinical stage I testicular cancer: protocol for a Danish nationwide cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e033713 ◽  
Author(s):  
Thomas Wagner ◽  
Birgitte Grønkær Toft ◽  
Birte Engvad ◽  
Jakob Lauritsen ◽  
Michael Kreiberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Testicular Cancer ◽  
Germ Cell ◽  
Clinical Stage ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
Stage I ◽  
Testicular Germ Cell ◽  
Testicular Germ Cell Cancer

IntroductionApproximately one-fourth of patients with clinical stage I testicular germ cell cancer will relapse within 5 years of follow-up. Certain histopathological features in the primary tumour have been associated with an increased risk of relapse. The available evidence on the prognostic value of the risk factors, however, is hampered by heterogeneity of the study populations included and variable reporting of the histopathological features. The aim of this study is to identify pathological risk factors for relapse in an unselected large nationwide cohort of patients with stage I disease.Methods and analysisAll incident cases of stage I testicular germ cell cancer diagnosed in Denmark between 2013 and 2018 will be identified using the nationwide prospective Danish Testicular Cancer (DaTeCa) database. Archived microscopic slides from the orchiectomy specimens will be retrieved through linkage to the Danish Pathology Data Bank and reviewed blinded to the clinical outcome. The DaTeCa database includes 960 stage I seminoma patients with expected 185 relapses and 480 patients with stage I non-seminoma with expected 150 relapses. A minimum follow-up period of 3 years of all patients will be ensured. Predefined prognostic variables will be investigated with regard to relapse in univariable and multivariable analysis using the Cox proportional hazards model.Ethics and disseminationThis study protocol has been approved by the Regional Ethics Committee (Region Zealand, Denmark) and the Danish Data Protection Agency. All data will be managed confidentially according to legislation. Study results will be presented at international conferences and published in peer-review journals.

The familial influence on bilateral testicular germ cell cancer: Medical Research Council study TER2

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4590-4590 ◽  
Author(s):  
S. J. Harland ◽  
G. Daugaard ◽  
A. Horwich ◽  
G. M. Mead ◽  
S. D. Fossa ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Age Of Onset ◽  
Cell Cancer ◽  
Major Effect ◽  
Primary Outcome Measure ◽  
Testis Cancer ◽  
Testicular Germ Cell ◽  
Hereditary Predisposition ◽  
Familial Predisposition ◽  
Bilateral Disease

4590 Background: There is evidence that hereditary predisposition is important in the aetiology of testicular cancer but the mode of inheritance is unknown. Methods: To test the hypothesis that bilateral disease (5% of testis cancer) is a manifestation of hereditary predisposition, a family questionnaire was sent to patients with bilateral disease (cases) and responses compared with institutional controls with unilateral disease (two approached for every case), matched for year of first diagnosis. The primary outcome measure was the risk of testis cancer in the brothers of cases and controls, and a relative risk of between 4.1 and 5.0 was anticipated based on the model of Nicholson and Harland (BJC 1995 71:421–426). Results: Responses from 191 cases and 373 controls have been analysed. No evidence of reduced fertility was found in the parents or grandparents of cases compared to those of controls. Cases (48%) were less likely to have children than controls (64%). The mean (SD) age of onset of testicular cancer was lower in cases (31 (9)) than controls (35 (9)), p < 0.001. The incidence of testis cancer in the relatives of cases and controls are shown in the table . Conclusions: The 4.6-fold greater risk to brothers of cases confirms the role of a familial predisposition in bilateral testicular cancer. Given the incomplete ascertainment for brothers, there is likely to be a greater risk to brothers than fathers. No major effect of an X-linked gene is found. These findings are in keeping with previously described hereditary models for testicular cancer. [Table: see text] No significant financial relationships to disclose.

scholarly journals A Study on Health Seeking Behaviors of Patients of Post-Kala-Azar Dermal Leishmaniasis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ariful Basher ◽  
Proggananda Nath ◽  
Shah Golam Nabi ◽  
Shahjada Selim ◽  
Md Fashiur Rahman ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Delay ◽  
Research Centre ◽  
Initial Symptom ◽  
Care Providers ◽  
System Delay ◽  
Health Seeking ◽  
Kala Azar ◽  
History Of

Post-Kala-Azar Dermal Leishmaniasis (PKDL) remains a major public health threat in Bangladesh. A cross-sectional study was carried out in Surya Kanta Kala azar Research Centre (SKKRC), Mymensingh, from January 2012 to July 2013 to evaluate the health seeking behaviour and the length of delay of PKDL management. The consecutive 200 diagnosed PKDL cases that got treatment in SKKRC hospital were subjected to evaluation. Most (98%) of the patients were not aware and had no knowledge about PKDL, though 87.5% had a history of history of Kala-azar treatment. Many patients reported first to village doctor (15.5%), the pharmacy shop (10%), or traditional health provider (7.5%) upon recognition of symptom. The time between the initial symptom recognition and first medical consultation (patient delay) ranged from 10 days to 4745 days (13 years) with a median of 373 days (mean: 696; IQR: 138 to 900 days). The time between first medical consultations to definite treatment (system delay) ranged from 0 days to 1971 days (5.4 years), with a median delay of 14 days (mean: 46.48; IQR: 7 to 44 days) that was reported in this study. Age, education, occupation, and residential status had significant association with patient delay (P<0.05). Educational status, occupation, number of treatment providers, and first health care provider had a significant association with system delay (P<0.05). Success in PKDL diagnosis and treatment requires specific behavior from patients and health care providers which facilitate those practices.

scholarly journals Hope and Life Engagement of Cancer Patıents at the Advanced Stage

2019 ◽  
Vol 4 (2) ◽  
pp. 19-25
Author(s):  
Nesrin Nural ◽  
Yasemin Çıracı Yaşar ◽  
Seçil Gülhan Güner
Keyword(s):  
Cancer Patients ◽  
Health Care Providers ◽  
Defense Mechanism ◽  
Psychosocial Support ◽  
Advanced Stage ◽  
Care Providers ◽  
Advanced Cancer Patients ◽  
Cross Sectional ◽  
Life Engagement ◽  
The Common

Introduction: Cancer is a clinical tableau in which many complicated physical and psychological problems are encountered and the individual’s defense mechanism against the process is often shaken. With the deterioration of the prognosis and the progression of the disease, individuals whose belief in healing is reduced may lose their life engagement and hope.Objective: The purpose of this cross-sectional and descriptive study is to determine the level of hope and life engagement of individuals with advanced stage cancer.Methods: The study was conducted with 74 advanced cancer patients who were hospitalized in the oncology, palliative care and surgery clinics of the Trabzon Kanuni Training and Research Hospital, fulfilled the research criteria and signed informed consent forms out of their free will. The data were collected using the “Demographic Information Form,” which included subjective questions, the “Integrative Hope Scale” consisting of four subscales, and the “Life Engagement Scale” in which the level of life engagement was detected. The data were analyzed by using the SPSS program and “ANOVA,” “Independent t-test” and “Correlation test” were used to analyze the relationship between the hope and life engagement scores and variables. The value p<.05 was accepted as statistically significant.Results: The common hope level mean of the patients included in the study was 104.5±6.8 and the common life engagement mean was 23.9±4.9. Correlating the significant differences in the subscales of the scale, the variables affecting the level of hope were determined as “ living place, fear of death, and despair,” and the variables affecting life engagement were determined as “education status, living place, ruefulness, and needing psychological support.”Conclusions: The psychosocial support and solidarity that the individual receives from other individuals in his environment and health care providers positively affects his selfconfidence, hope and life engagement. On the other hand, contrary to the meaning of “I am not afraid of dying,” this statement can be considered an expression of giving up on life. Nurses should focus on the messages underlying what the patients say.

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