Does neighborhood deprivation influence stage at diagnosis for testicular cancer? A statewide cohort analysis
Recommended Citation
Cusmano NB, Bertini A, Finocchiaro A, Vigano S, Tylecki A, Stephens A, Dinesh A, Robinson B, Guivatchian E, Buffi N, Lughezzani G, Di Trapani E, Ficarra V, Salonia A, Briganti A, Montorsi A, Rogers C, Abdollah F. Does neighborhood deprivation influence stage at diagnosis for testicular cancer? A statewide cohort analysis. Eur Urol 2025; 87(S1):1207.
Document Type
Conference Proceeding
Publication Date
3-1-2025
Publication Title
Eur Urol
Abstract
Introduction & Objectives: Testicular cancer is a relatively rare but highly curable malignancy, making early diagnosis a key factor to survivorship. Previous studies have demonstrated how low education level and living in areas with low income corresponded to higher stage at diagnosis. However, very few studies have targeted Area Deprivation Index (ADI), which is a robust measure of socioeconomic status (SES) that considers factors including income, education, employing, and housing quality. We aim to assess the association between ADI and the stage at diagnosis of testicular cancer patients. Materials & Methods: The Michigan Department of Health and Human Services (MDHHS) was retrospectively queried for patients aged 15 or older that were diagnosed with histologically confirmed testicular cancer between the years of 2004 and 2019. ADI was assigned to each patient dependent upon their residential census block group and ranked as a percentile of deprivation in comparison to the national level. We further stratified the cohort into 4 quartiles based on national ADI values, with the 4th quartile (75-100) being the most deprived. Logistic regression tested the impact of ADI on testicular cancer stage at diagnosis, after accounting for all available covariates. Stage I was defined as any pT;N0;M0, Stage II was defined as any pT;N1-3;M0, and Stage III was defined as any pT; any N;M1. Unfortunately, data regarding Clinical S was not available. Results: A total 2625 patients were analyzed that were 94% White, with a median age of 34 years (IQR 27-43). 60.7% of the patients were diagnosed with a seminoma while the remaining 39.3% were non-seminoma. Overall, 78.4%, 13.8%, and 7.8% were Stage I, II, and III respectively. Stage III at diagnosis was 4.8%, 8.3%, 6.9%, and 9.6% in ADQ quartiles 1, 2, 3, and 4, respectively (p=.1). On multivariable analysis, for each 10 unit increase in ADI, the odds of metastatic (Stage III) testicular cancer increases by 7% (95% CI: 1.01-1.13, p=.03). Conclusions: Our study highlights how living in more deprived neighborhoods was associated with an increased risk of metastatic testicular cancer at diagnosis. This demonstrates how resource poor areas can act as a barrier to earlier diagnosis and emphasizes the need for interventions to address these disparities.
Volume
87
Issue
S1
First Page
1207
