Decreased survival of black Americans with testicular cancer

Purpose: A 14-year review of 215 consecutive patients with testicular cancer at the University of Illinois hospitals revealed that 25% were black. This large experience with this relatively rare cancer in black men provides a unique opportunity to compare the disease stage at presentation, histological tumor type and 5-year survival rates of black, white and Hispanic men. Materials and Methods: We reviewed the records of patients with a diagnosis of testicular cancer treated at University of Illinois hospitals. The Kaplan-Meier method was used to calculate actuarial 5-year survival rates. Results: The overall percentages of white, black and Hispanic men were 55 (119 men), 25 (53) and 18% (38), respectively. We found no significant differences in tumor types among the 3 racial groups. Overall 42 and 58% of the patients had seminoma and nonseminoma, respectively. Black men with some types of cancer have been shown to present with higher stages of disease but we noted no differences in clinical stage at presentation in all groups with testicular cancer (average stage I disease in 45%, II in 31% and-III in 24%). Survival rates were 88% in white, 79% in Hispanic and 71% in black patients. Conclusions: Black men had significantly decreased (z<0.02) 5-year disease specific survival, which was 17% less than white patients. The difference in disease specific survival for Hispanic men was not statistically significant. This review of 215 patients with testicular cancer revealed no differences in tumor type or stage at presentation for white, black or Hispanic men. However, a review of these data suggests that disease specific survival outcomes are more ominous in black men.