Objective: Testis cancer is the most common cancer in young men, and its incidence continues to rise. Even if prognosis is considered as good, a group with bad prognosis still remains. Diagnostic delay (DD), defined as the time elapsing from the onset of tumour symptoms to the day of diagnosis, is a way to evaluate the rapidity of diagnosis. We assessed the relationship between DD, disease stage, and survival rate.
Methods: A series of 542 patients diagnosed with a germ cell tumour between 1983 and 2002 at health facilities in the Midi-Pyrenees region, southwest France, were asked about DD. We analysed DD together with data regarding the disease (histologic type, stage), its treatments, and prognosis (impact on survival).
Results: Mean DD was longer in seminoma (4.9+/-6.1 mo) than in non-seminomatous germ cell tumour (NSGCT; 2.8+/-4.0 mo). DD was correlated with disease stage for the whole population (p=0.014) and for NSGCT (p=0.0009), but not for seminoma. DD had a significant impact on the 5-yr survival rate in the overall population (p=0.001) and in the NSGCT group (p=0.001), but not in the seminoma group. Global trends in mean DD did not change over the 20-yr study period, but we observed a slight decrease during the last decade.
Conclusions: DD is highly correlated with stage and survival in NSGCT. Urologists should promote programmes to enhance awareness and knowledge of testis cancer, so the diagnosis can be made more rapidly.
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