Patients without insurance and those with Medicaid have an increased risk of presenting with advanced testicular cancer and cancer-related death compared with those who have insurance, a study published in the journal Cancer has shown.1

People age 26 to 34 years represent the largest proportion of insured Americans, and they also have the highest incidence of testicular cancers. Therefore, researchers sought to evaluate the association between insurance status and cancer outcomes in patients diagnosed with germ cell tumors.

For the study, investigators analyzed data from 10,211 men with germ cell gonadal neoplasms diagnosed between 2007 and 2011 who were included in the Surveillance, Epidemiology, and End Results (SEER) database.

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Results showed that uninsured patients had a 26% increased risk of metastatic disease at the time of diagnosis (relative risk [RR], 1.26; 95% CI, 1.15-1.38) compared with insured patients, while Medicaid patients had a 62% higher risk (RR, 1.62; 95% CI, 1.51-1.74) vs insured patients.

Among those with metastatic disease, uninsured and Medicaid patients were 22% (RR, 1.22; 95% CI, 1.04-1.44) and 39% (RR, 1.39; 95% CI, 1.23-1.57) more likely to be diagnosed with intermediate/poor-risk disease, respectively.

Researchers also found that men without insurance were 88% more likely to die from testicular cancer (hazard ratio [HR], 1.88; 95% CI, 1.29-2.75) in comparison with insured men. Those with Medicaid had a 58% higher risk of cancer-related death than their insured counterparts (HR, 1.58; 95% CI, 1.16-2.15).


1. Markt SC, Lago-Hernandez CA, Miller RE, et al. Insurance status and disparities in disease presentation, treatment, and outcomes for men with germ cell tumors. Cancer. 2016 Aug 8. doi: 10.1002/cncr.30159. [Epub ahead of print].