Testicular cancer disparities in the second decade of the 21st century

BACKGROUND: Data on how socioeconomic inequalities affect testicular cancer (TC) survival are limited. METHODS: Using the SEER database, we established 5-year overall survival (OS) and determined cancer-specific survival (CSS) via log-rank tests. Cox proportional hazards models assessed the influence of socioeconomic factors on OS and CSS, accounting for clinical factors. Hazard ratios (HR) and survival rates were reported with 95% confidence intervals (CI). RESULTS: Among 11,356 patients, each additional year of age worsened OS (HR 1.05 [1.04-1.06]) and CSS (HR 1.03 [1.02-1.04]). Nonseminoma histology and higher stage worsened OS and CSS. OS was worse in non-Hispanic Black (HR 1.91 [1.21-2.88]) and Hispanic patients (HR 1.27 [1.03-1.57]). CSS was worse in non-Hispanic American Indian/Alaska Native patients (HR 2.64 [1.11-5.29]). CSS was lower in patients earning $40,000 to $59,000 (HR 1.98 [1.03-3.89]); OS was lower in those earning $40,000 to $59,999 (HR 1.67 [1.02-2.77]) and $60,000 to $79,999 (HR 1.51 [1.06-2.21]). Area of residence population density did not affect OS or CSS. Unmarried patients had worse OS (HR 1.81 [1.45-2.26]) and CSS (HR 1.76 [1.3-2.41]). CONCLUSIONS: OS was worse among non-Hispanic Blacks, Hispanics, and those with incomes of $60,000 to $79,999.