In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the EU average. We prospectively evaluated the effect of socioeconomic position on patient delay and therapy outcomes. Questionnaires on subjective social status (MacArthur Subjective Status Scale), objective socioeconomic position (wealth, education, and housing data), and on patient’s delay were completed by newly diagnosed TGCC patients. Patients belonged to a relatively high socioeconomic class, a university degree was double the Hungarian average, Cancer-specific mortality in the highest social quartile was 1.56% while in the lowest social quartile 13.09% (p = 0.02). In terms of patient delay, 57.2% of deceased patients waited more than a year before seeking help, while this number for the surviving patients was 8.0% (p = 0.0000). Longer patient delay was associated with a more advanced stage in non-seminoma but not in seminoma, the correlation coefficient for non-seminoma was 0.321 (p < 0.001). For patient delay, the most important variables were the mother’s and patient’s education levels (r = − 0.21, p = 0.0003, and r = − 0.20, p = 0.0005), respectively. Since the patient delay was correlated with the social quartile and resulted in a more advanced stage in non-seminoma, the lower social quartile resulted in higher mortality in non-seminoma patients (p = 0.005) but not in seminoma patients (p = 0.36) where the patient delay was not associated with a more advanced stage. Based on our result, we conclude that to improve survival, we should promote testicular cancer awareness, especially among the most deprived populations, and their health care providers.

中文翻译：

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一项前瞻性研究，社会经济地位低是匈牙利睾丸癌患者延迟治疗和死亡的危险因素

在匈牙利，睾丸生殖细胞癌 (TGCC) 的死亡率为 0.9/100000，明显高于欧盟平均水平。我们前瞻性地评估了社会经济地位对患者延迟和治疗结果的影响。关于主观社会地位（麦克阿瑟主观地位量表）、客观社会经济地位（财富、教育和住房数据）和患者延误的问卷由新诊断的 TGCC 患者完成。患者属于相对较高的社会经济阶层，大学学位是匈牙利平均水平的两倍，最高社会四分位数的癌症特异性死亡率为 1.56%，而最低社会四分位数为 13.09% (p = 0.02)。在患者延误方面，57.2% 的已故患者在寻求帮助前等待了一年以上，而幸存患者的这一数字为 8.0%（p = 0. 0000）。较长的患者延迟与非精原细胞瘤的晚期阶段相关，但与精原细胞瘤无关，非精原细胞瘤的相关系数为 0.321 (p < 0.001)。对于患者延误，最重要的变量分别是母亲和患者的教育水平（r = - 0.21，p = 0.0003，和 r = - 0.20，p = 0.0005）。由于患者延迟与社会四分位数相关并导致非精原细胞瘤的晚期阶段，较低的社会四分位数导致非精原细胞瘤患者的死亡率较高（p = 0.005），但在精原细胞瘤患者中则不然（p = 0.36）其中患者延迟与更高级的阶段无关。根据我们的结果，我们得出结论，为了提高生存率，我们应该提高对睾丸癌的认识，尤其是在最贫困的人群及其医疗保健提供者中。较长的患者延迟与非精原细胞瘤的晚期阶段相关，但与精原细胞瘤无关，非精原细胞瘤的相关系数为 0.321 (p < 0.001)。对于患者延误，最重要的变量分别是母亲和患者的教育水平（r = - 0.21，p = 0.0003，和 r = - 0.20，p = 0.0005）。由于患者延迟与社会四分位数相关并导致非精原细胞瘤的晚期阶段，较低的社会四分位数导致非精原细胞瘤患者的死亡率较高（p = 0.005），但在精原细胞瘤患者中则不然（p = 0.36）其中患者延迟与更高级的阶段无关。根据我们的结果，我们得出结论，为了提高生存率，我们应该提高对睾丸癌的认识，尤其是在最贫困的人群及其医疗保健提供者中。较长的患者延迟与非精原细胞瘤的晚期阶段相关，但与精原细胞瘤无关，非精原细胞瘤的相关系数为 0.321 (p < 0.001)。对于患者延误，最重要的变量分别是母亲和患者的教育水平（r = - 0.21，p = 0.0003，和 r = - 0.20，p = 0.0005）。由于患者延迟与社会四分位数相关并导致非精原细胞瘤的晚期阶段，较低的社会四分位数导致非精原细胞瘤患者的死亡率较高（p = 0.005），但在精原细胞瘤患者中则不然（p = 0.36）其中患者延迟与更高级的阶段无关。根据我们的结果，我们得出结论，为了提高生存率，我们应该提高对睾丸癌的认识，尤其是在最贫困的人群及其医疗保健提供者中。