Presentation (CTI)

OBJECTIVES: Testicular Cancer (TCa) is the most common solid malignancy among young men. TCa’s favorable prognosis is highly stage dependent yet diagnostic delay has been a recognized problem for over four decades. Few studies have leveraged large-scale, nationally representative samples to characterize the pre-diagnostic workup patterns for TCa. We sought to understand the diagnostic journey of newly diagnosed males with TCa using real-world US EHR linked to claims data.
METHODS: This study used the Veradigm Network EHR linked to Komodo administrative claims to identify males aged 15-45 with a new TCa diagnosis between 01/01/2024-03/07/2026. Earliest TCa diagnosis=index date. Males with a history of TCa prior to index date were excluded. Using all available patient history, the presence of relevant lab testing (AFP, LDH, B-HcG) and procedures (CT scan, ultrasound, orchiectomy) prior to diagnosis were examined. Additionally, time from initial complaint (ER and office visits with related symptoms, including but not limited to: back pain, groin pain, swelling, night sweats) to diagnosis date was calculated. The presence of visits with a documented TCa screening prior to diagnosis was also captured.
RESULTS: A total of 4,302 patients were included in the analysis. Less than a third (26%) had a procedure for a CT scan (abdomen, pelvis, or chest) any time prior to TCa diagnosis. Approximately 10% had an AFP lab result, and <10% had an LDH (9.3%) or B-HcG (8.7%) lab result. Less than 5% had documented evidence of pelvic/perineal pain or swelling prior to the diagnosis date and 0.5% had a TCa screening.
CONCLUSIONS: Our analysis of US real world data in males with newly diagnosed TCa found that diagnostic workups are lacking. A majority of males had no evidence of relevant labs or procedures prior to the diagnosis date and <1% had evidence of a documented visit with TCa screening.