Racial disparities in incidence-based mortality and survival outcomes in testicular cancer in adolescent and young adults.

Abstract

650 Background: Testicular cancer is the most common malignancy in males aged 15-35, with increasing incidence worldwide. Despite overall high survival rates, significant outcome disparities persist across race, socioeconomic status, and geographic location. Addressing these disparities is crucial to ensure equitable access to early diagnosis, treatment, and supportive care for all patients. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 17 Research database program was utilized to obtain the annual percentage change (APC) in incidence of testicular cancer from 2000 - 2021 for patients aged 15 - 39 years (AYA group). Patient characteristics were expressed in proportions (%). The Kaplan Meier method was used to determine overall survival (OS) and cancer-specific survival (CSS). Cox regression was performed to determine predictors of survival. A p-value ≤0.05 was considered statistically significant. Results: A total of 19680 met our specified criteria and were included in our studies. We excluded cases with unknown race, and non testicular cancer cases. Our reference race was Hispanics. Compared to Hispanics. Non hispanic American Indian/Alaska Native had HR 1.696, (CI 1.290-2.229, p < 0.001, Non hispanic Asian/Pacific Islander had HR 0.880 (CI 0.712-1.087, p = 0.234), Non Hispanic Blacks had HR 1.608 (CI 1.267-2.039, p < 0.001), Non Hispanic Whites had HR 0.770 (CI 0.682-0.870, p < 0.001). Conclusions: Our study reveals significant racial disparities in testicular cancer survival outcomes with Non hispanic American Indian/Alaska Native and Non Hispanic Blacks having higher mortality risk. These findings highlight the need for targeted interventions to address survival disparities in testicular cancer across different racial and ethnic groups within the AYA demographic.