Testicular Tumors: Presentation and Role of Diagnostic Delay

Abstract

180 patients with testicular germ cell tumors were evaluated in a retrospective study concerning the features of presentation and diagnostic delay. Mean duration of symptoms was 170 days, being different for semi-noma and nonseminoma, and showing a continuous decrease since 1969. Duration of symptoms was longest in stage I seminoma. In the nonseminoma group the longest interval was observed in stage III. It is concluded that only in nonseminoma a prolonged delay exerts adverse effects on prognosis. Short delay (cryosperm conservation) does not seem to cause any harm. A plea is made for periodic testicular self-examination.

Testicular cancer: A narrative review of the role of socioeconomic position from risk to survivorship

“…Late stage diagnosis of TGCT, particularly nonseminomatous TC, has been shown to be a risk factor for increased TGCT-specific mortality [40,60]. We were able to find 2 studies that specifically address the association of stage at diagnosis of TC and SEP. Dieckmann et al found that lower educational levels were related to delays in diagnosis for nonseminomatous TGCT in 180 German men [60].…”

“…Late stage diagnosis of TGCT, particularly nonseminomatous TC, has been shown to be a risk factor for increased TGCT-specific mortality [40,60]. We were able to find 2 studies that specifically address the association of stage at diagnosis of TC and SEP. Dieckmann et al found that lower educational levels were related to delays in diagnosis for nonseminomatous TGCT in 180 German men [60]. In contrast, Toklu and colleagues reported on 140 Turkish men seen in their clinic from 1994-1995 and found that stage of diagnosis did not statistically differ by income level or between college graduates versus non-college graduates [40].…”

“…Papers were further excluded for the following reasons: there was no SEP information reported in the paper (10), they were letters or commentaries (3), or they were older reviews (9). The reference lists of the remaining 41 papers were reviewed and 5 [60][61][62][63][64] additional papers were identified. We abstracted information on SEP, including occupation, education, income, and combinations of the 3.…”

“…Few studies have examined SEP and stage at diagnosis among TC patients, and it is conceivable that patients with lower SEP and limited access to care would have delays in diagnosis [40,60]. Late stage diagnosis of TGCT, particularly nonseminomatous TC, has been shown to be a risk factor for increased TGCT-specific mortality [40,60].…”

Early detection and treatment of certain malignant tumors

“…Several studies have shown that delay in presentation is common and may result in metastases and increased mortality and morbidity, especially for patients with nonseminoma. [9][10][11][12] As stage is one of the most significant determinants of survival, the earlier we can detect TC, the greater chance we could achieve longer survival. Early detection of TC theoretically can be improved by spreading medical information on the importance of selfexamination and the curability of TC, and on multimodal treatment possibilities.…”