Evidence map›Paper›PMID 39456120›Full record

ArticleBJU international2025

Insurance remains a major source of disparity for patients with testicular cancer: call for advocacy.

Savannah Starr, Jj Zhang, Lin Lin, Jolie Shen, Giovanni Gamalong, Mark S Litwin, Alexandra Drakaki, Karim Chamie

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJU international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Savannah StarrDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.ORCID https://orcid.org/0000-0002-0563-6070
Jj ZhangDepartment of Urology, Virginia Mason Medical Center, Seattle, CA, USA.
Lin LinDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Jolie ShenDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Giovanni GamalongDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.ORCID https://orcid.org/0000-0001-9942-4636
Mark S LitwinDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Alexandra DrakakiDepartment of Medical Oncology, University of California, Los Angeles, CA, USA.
Karim ChamieDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Funding

Women's CancersP30CA016042 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Robert Damoiseaux · 1985 to 2026
$134.5M
NCI NIH HHS P30 CA016042
6 · The paper itself

Abstract

objectiveTo evaluate the effects of socioeconomic factors, including insurance status, on treatment and survival for patients with testicular cancer. PATIENTS AND

methodsWe extracted a retrospective cohort from the National Cancer Database that included patients diagnosed with testicular cancer 2004-2020. Competing-risks and Cox regression multivariate models including demographic, pathological, and socioeconomic covariates were constructed to evaluate receipt of treatment and death, respectively.

resultsA total of 95 955 patients with testicular cancer were identified. Compared with private insurance, Medicaid (sub-distribution hazard ratio [SHR] 0.70, P < 0.001), Medicare (SHR 0.73, P < 0.001), and uninsured (SHR 0.72, P < 0.001) patients were associated with decreased likelihood of receiving chemotherapy. Compared with private insurance, Medicaid (SHR 0.55, P < 0.001), Medicare (SHR 0.76, P-value <0.001), uninsured (SHR 0.63, P-value < 0.001), and other government insurance (SHR 0.71, P = 0.010) was associated with decreased likelihood of receiving radiation. Medicaid insurance status (reference private, HR 2.60, P < 0.001) conferred the second largest hazard of death, behind having Stage III disease (reference Stage 0). Compared with private insurance, Medicare (HR 2.20, P < 0.001), no insurance (HR 2.32, P < 0.001), and other government insurance (HR 1.53, P = 0.027) statuses had higher risk of death. Patients diagnosed in Medicaid-expansion states had lower all-cause mortality (11.4% vs 13.6%, P < 0.001).

conclusionsTesticular cancer care relies on early diagnosis and treatment. It is critically important to have a healthcare system where individuals have access to insurance and are served equitably.

Indexed as

Healthcare DisparitiesInsurance CoverageInsurance, HealthTesticular NeoplasmsAdultHumansMaleMedicaidMedically UninsuredMedicareMiddle AgedRetrospective StudiesSocioeconomic FactorsUnited StatesYoung Adultdisparitiesinsurance statusMedicaid expansionsocial determinants of healthtesticular cancer

Identifiers

PMID39456120
PMCPMC11745997

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.