Quality of life among germ-cell testicular cancer survivors: The effect of time since cancer diagnosis

PLoS One. 2021 Oct 6;16(10):e0258257. doi: 10.1371/journal.pone.0258257. eCollection 2021.

Abstract

Introduction: Testicular cancer is one of the most treatable cancers, with a 10-year survival of more than 95%. Many patients will be long-term survivors and this disease strikes men in an important phase of their lives, therefore the quality of life (QoL) among these patients is an area of particular interest. We aimed to study whether QoL in testicular cancer survivors depends on the time since cancer diagnosis.

Methods: Data were collected from the EPSAM (Esposizioni postnatali e salute maschile) study, a case-control study on patients with testicular cancer, diagnosed between 1997 and 2008 in the province of Turin, Northern Italy, and interviewed between 2008 and 2010 (response rate among cases 57%). Patients were contacted through their oncologist at the San Giovanni Batista Hospital in Turin or through their general practitioner (GP) in the rest of the Province of Turin. QoL was assessed cross-sectionally using the short form 12 (SF-12) questionnaire, a generic short-form health survey that produces two summary scores, PCS (physical component score) and MCS (mental component score), to evaluate physical and mental health, respectively.

Results: Out of 234 study patients, 125 cases were seminomas and 109 cases were nonseminomas. The mean age at diagnosis was 34.5 years. After adjusting for age, time since diagnosis was not associated with PCS and MCS scores. Among nonseminomas, the median PCS slightly increased (adjusted OR (odds ratio) for 5+ vs < 2 years since cancer diagnosis: 1.78 (1.17-2.73), p = 0.008) and MCS slightly decreased (adjusted OR per 1-year increase since cancer diagnosis: 0.92, 95% CI: 0.82-1.05, p = 0.23) with time. Similar findings of no association between time since diagnosis and PCS and MCS were found when the analyses were restricted to the subgroup of cancer patients contacted through their oncologist, whose response proportion was 82%.

Conclusion: In a study of testicular cancer patients interviewed cross-sectionally at 1 to more than 10 years since diagnosis, time since cancer diagnosis was not associated with QoL when we considered all germ-cell testicular cancer patients together. When stratified by histology type, we found certain evidence that nonseminoma cases report higher PCS over time since cancer diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cancer Survivors / psychology*
  • Confidence Intervals
  • Early Detection of Cancer / psychology*
  • Humans
  • Logistic Models
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal / psychology*
  • Odds Ratio
  • Quality of Life / psychology*
  • Testicular Neoplasms / psychology*
  • Time Factors
  • Young Adult

Supplementary concepts

  • Testicular Germ Cell Tumor

Grants and funding

This work was partially supported by the Piedmont Region. AJ received scholarships from the European Commission through the Erasmus Mundus for Western Balkans II programme, Grant Agreement 2011-2586/001-001-EMA2. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no relevant financial or non-financial disclosure interests.