Standardized, expert care can overcome factors associated with worse clinical outcomes in testicular cancer

New research suggests that although sociodemographic factors have been associated with poor outcomes for patients treated for testicular cancer, guideline-directed, expert care can help to address this issue. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society (ACS).

Numerous barriers to optimal treatment for testicular cancer exist in underserved populations, such as individuals from ethnic minorities and lower socioeconomic strata. A team led by Aditya Bagrodia, MD, of the University of Texas Southwestern Medical Center in Dallas, examined whether standardized care may help to overcome these barriers and lead to better health outcomes.

At the investigators' institution, the same group of diverse physicians takes care of patients with testicular cancer at two separate hospitals with different patient populations.

One hospital is a safety net hospital for the people of Dallas County (Parkland Memorial Hospital) and the second (UT Southwestern Medical Center's Harold C. Simmons Comprehensive Cancer Center) is an academic tertiary care center and National Cancer Institute-designated Comprehensive Cancer Center that sees mostly patients with private insurance or Medicare.

For the study, the medical records of all patients undergoing treatment for testicular cancer from 2006 to 2018 were analyzed from both the safety net hospital and the academic center. A total of 106 patients received care at the safety net hospital, and 95 were treated at the academic center.

The researchers noted differences between the two groups regarding insurance status, cancer stage at the time of diagnosis, and other factors, but cancer recurrence and mortality rates were similar.

Despite stark differences in patient demographics that are usually associated with worse clinical outcomes--including lack of health insurance, delayed presentation, lack of primary care physicians, and minority ethnicity status--we found that standardized care with a multidisciplinary team led to no differences in the way patients were managed and equivalent clinical outcomes."

Aditya Bagrodia, MD, Southwestern Medical Center, University of Texas

"This study illustrates that standardized, expert care can overcome factors generally associated with worse clinical outcomes."