Distribution of Serum Tumor Markers for Testicular Cancer across Racial/Ethnic Groups from 2004 to 2007 in the United States Público

Abstract

Distribution of Serum Tumor Markers for Testicular Cancer across Racial/Ethnic Groups from 2004 to 2007 in the United States
By Tiffany Hosten

Objective: While the incidence of testicular cancer is lower among Non-Hispanic Black men
compared to U.S. men of other races and ethnicities, Black testicular cancer patients have poorer
survival. Social factors may account for this observed disparity in outcome, however, biological
tumor characteristics including levels of prognostic testicular tumor markers such as alpha
fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH) have
not previously been compared across racial and ethnic groups on a population level.
Methods: Using the Surveillance, Epidemiology, and End Results (SEER) public-access dataset
from 2004 through 2007, the distributions of tumor markers for testicular cancer cases were
compared in three groups of patients: Non-Hispanic Whites, Non-Hispanic Blacks, and
Hispanics. Association between elevated levels of each marker and race/ethnicity was examined
using multivariate logistic regression models with results expressed as adjusted odds ratios (ORs)
and 95% confidence intervals (CIs).
Results: We found that Hispanics were more likely than Non-Hispanic Whites to have elevated
LDH with OR (95% CI) 1.5 (1.2-1.8), while the corresponding result for Blacks in comparison to
Whites was 1.5 (1.0-2.5). No difference in frequency of elevated serum tumor marker levels was
observed across race/ethnicity for AFP and hCG.
Conclusion: Racial/ethnic disparities in testicular cancer survival are more likely to be explained
by the differences in early detection, access to care, care utilization, and quality of care than by
the differences in biological tumor characteristics. Future studies should explore tumor marker
distributions among additional racial groups and use SEER's new, more uniformly coded site-
specific variables.

Table of Contents

Background and Literature Review ............................................................................................ 1
Methods .............................................................................................................................. 6
Results .............................................................................................................................. 10
Discussion .......................................................................................................................... 12
References ......................................................................................................................... 15
Tables ............................................................................................................................... 18

Table 1 ...................................................................................................................... 18
Table 2 ...................................................................................................................... 19
Table 3 ...................................................................................................................... 20
Table 4 ...................................................................................................................... 21

Figures and Figure Legends .................................................................................................... 22

Figure 1 ..................................................................................................................... 22

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Palabra Clave	SEER ethnicity disparities tumor markers race testicular cancer
Committee Chair / Thesis Advisor	Goodman, Michael, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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