Do learning disabilities affect testicular cancer survival: a national cohort study between 2001 and 2015

Mehran Afshar; Hiten R H Patel; Maria De-Santis; Jamie-Rae Tanner; Tess O'Neill; Felicity Evison; Nicholas D James; Peter J Selby; Prashant Patel

doi:10.1016/j.euo.2018.12.008

Do learning disabilities affect testicular cancer survival: a national cohort study between 2001 and 2015

Mehran Afshar, Hiten R H Patel, Maria De-Santis, Jamie-Rae Tanner, Tess O'Neill, Felicity Evison, Nicholas D James, Peter J Selby, Prashant Patel

Cancer and Genomic Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Some 1.5 million people in the UK have a learning disability (LD). This vulnerable group derives less benefit from population-based education programs. They are prone to underenrolment in screening programs and may lack the ability to perform self-examination.

OBJECTIVE: To identify patients with LD in England and assess their testicular cancer (TC) survival in comparison to the general population.

DESIGN, SETTING, AND PARTICIPANTS: Patient records were identified from the Hospital Episode Statistics database. All patients resident in England with a diagnosis of mental debility, "developmental disorder of scholastic skills", or attending under the specialty of LD between April 1, 2001 and June 30, 2015 were included.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We measured survival outcomes according to the Kaplan-Meier method and used log-rank tests to assess survival difference between demographic groups.

RESULTS AND LIMITATIONS: Of 158138 male patients with LD, 331 had TC and 32 died of cancer. LD patients had a poorer prognosis, with 10-yr TC-specific survival of 88.4% (95% confidence interval [CI] 84.5-92.4%) in the LD group versus 96.8% (95% CI 96.6-97.1%) in the non-LD group. LD patients also had lower all-cause survival rates. The 10-yr survival rate was 77.6% (95% CI 72.2-83.3%) for LD patients versus 89.9% (95% CI 89.4-90.3%) for non-LD patients, while the corresponding 5-yr rates were 84% (95% CI 79.9-88.4%) versus 92.2% (95% CI 91.8-92.5%).

CONCLUSIONS: Education regarding self-examination for TC must be provided in a format suitable for those with LD. Carers for male patients with LD should be informed about testicular examination and sinister signs.

PATIENT SUMMARY: Testicular cancer patients who also have a learning disability (LD) have a one in nine chance of dying, compared to a one in 36 chance for testicular cancer patients without LD. This is because patients with LD are less likely to detect the disease at an earlier stage.

Original language	English
Pages (from-to)	773-779
Number of pages	7
Journal	European Urology Oncology
Volume	3
Issue number	6
Early online date	14 Jan 2019
DOIs	https://doi.org/10.1016/j.euo.2018.12.008
Publication status	Published - Dec 2020

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@article{f3184311c39d4f97b239a6f779335997,

title = "Do learning disabilities affect testicular cancer survival: a national cohort study between 2001 and 2015",

abstract = "BACKGROUND: Some 1.5 million people in the UK have a learning disability (LD). This vulnerable group derives less benefit from population-based education programs. They are prone to underenrolment in screening programs and may lack the ability to perform self-examination.OBJECTIVE: To identify patients with LD in England and assess their testicular cancer (TC) survival in comparison to the general population.DESIGN, SETTING, AND PARTICIPANTS: Patient records were identified from the Hospital Episode Statistics database. All patients resident in England with a diagnosis of mental debility, {"}developmental disorder of scholastic skills{"}, or attending under the specialty of LD between April 1, 2001 and June 30, 2015 were included.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We measured survival outcomes according to the Kaplan-Meier method and used log-rank tests to assess survival difference between demographic groups.RESULTS AND LIMITATIONS: Of 158138 male patients with LD, 331 had TC and 32 died of cancer. LD patients had a poorer prognosis, with 10-yr TC-specific survival of 88.4% (95% confidence interval [CI] 84.5-92.4%) in the LD group versus 96.8% (95% CI 96.6-97.1%) in the non-LD group. LD patients also had lower all-cause survival rates. The 10-yr survival rate was 77.6% (95% CI 72.2-83.3%) for LD patients versus 89.9% (95% CI 89.4-90.3%) for non-LD patients, while the corresponding 5-yr rates were 84% (95% CI 79.9-88.4%) versus 92.2% (95% CI 91.8-92.5%).CONCLUSIONS: Education regarding self-examination for TC must be provided in a format suitable for those with LD. Carers for male patients with LD should be informed about testicular examination and sinister signs.PATIENT SUMMARY: Testicular cancer patients who also have a learning disability (LD) have a one in nine chance of dying, compared to a one in 36 chance for testicular cancer patients without LD. This is because patients with LD are less likely to detect the disease at an earlier stage.",

author = "Mehran Afshar and Patel, {Hiten R H} and Maria De-Santis and Jamie-Rae Tanner and Tess O'Neill and Felicity Evison and James, {Nicholas D} and Selby, {Peter J} and Prashant Patel",

note = "Copyright {\textcopyright} 2018. Published by Elsevier B.V.",

year = "2020",

month = dec,

doi = "10.1016/j.euo.2018.12.008",

language = "English",

volume = "3",

pages = "773--779",

journal = "European Urology Oncology",

issn = "2588-9311",

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TY - JOUR

T1 - Do learning disabilities affect testicular cancer survival

T2 - a national cohort study between 2001 and 2015

AU - Afshar, Mehran

AU - Patel, Hiten R H

AU - De-Santis, Maria

AU - Tanner, Jamie-Rae

AU - O'Neill, Tess

AU - Evison, Felicity

AU - James, Nicholas D

AU - Selby, Peter J

AU - Patel, Prashant

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND: Some 1.5 million people in the UK have a learning disability (LD). This vulnerable group derives less benefit from population-based education programs. They are prone to underenrolment in screening programs and may lack the ability to perform self-examination.OBJECTIVE: To identify patients with LD in England and assess their testicular cancer (TC) survival in comparison to the general population.DESIGN, SETTING, AND PARTICIPANTS: Patient records were identified from the Hospital Episode Statistics database. All patients resident in England with a diagnosis of mental debility, "developmental disorder of scholastic skills", or attending under the specialty of LD between April 1, 2001 and June 30, 2015 were included.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We measured survival outcomes according to the Kaplan-Meier method and used log-rank tests to assess survival difference between demographic groups.RESULTS AND LIMITATIONS: Of 158138 male patients with LD, 331 had TC and 32 died of cancer. LD patients had a poorer prognosis, with 10-yr TC-specific survival of 88.4% (95% confidence interval [CI] 84.5-92.4%) in the LD group versus 96.8% (95% CI 96.6-97.1%) in the non-LD group. LD patients also had lower all-cause survival rates. The 10-yr survival rate was 77.6% (95% CI 72.2-83.3%) for LD patients versus 89.9% (95% CI 89.4-90.3%) for non-LD patients, while the corresponding 5-yr rates were 84% (95% CI 79.9-88.4%) versus 92.2% (95% CI 91.8-92.5%).CONCLUSIONS: Education regarding self-examination for TC must be provided in a format suitable for those with LD. Carers for male patients with LD should be informed about testicular examination and sinister signs.PATIENT SUMMARY: Testicular cancer patients who also have a learning disability (LD) have a one in nine chance of dying, compared to a one in 36 chance for testicular cancer patients without LD. This is because patients with LD are less likely to detect the disease at an earlier stage.

AB - BACKGROUND: Some 1.5 million people in the UK have a learning disability (LD). This vulnerable group derives less benefit from population-based education programs. They are prone to underenrolment in screening programs and may lack the ability to perform self-examination.OBJECTIVE: To identify patients with LD in England and assess their testicular cancer (TC) survival in comparison to the general population.DESIGN, SETTING, AND PARTICIPANTS: Patient records were identified from the Hospital Episode Statistics database. All patients resident in England with a diagnosis of mental debility, "developmental disorder of scholastic skills", or attending under the specialty of LD between April 1, 2001 and June 30, 2015 were included.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We measured survival outcomes according to the Kaplan-Meier method and used log-rank tests to assess survival difference between demographic groups.RESULTS AND LIMITATIONS: Of 158138 male patients with LD, 331 had TC and 32 died of cancer. LD patients had a poorer prognosis, with 10-yr TC-specific survival of 88.4% (95% confidence interval [CI] 84.5-92.4%) in the LD group versus 96.8% (95% CI 96.6-97.1%) in the non-LD group. LD patients also had lower all-cause survival rates. The 10-yr survival rate was 77.6% (95% CI 72.2-83.3%) for LD patients versus 89.9% (95% CI 89.4-90.3%) for non-LD patients, while the corresponding 5-yr rates were 84% (95% CI 79.9-88.4%) versus 92.2% (95% CI 91.8-92.5%).CONCLUSIONS: Education regarding self-examination for TC must be provided in a format suitable for those with LD. Carers for male patients with LD should be informed about testicular examination and sinister signs.PATIENT SUMMARY: Testicular cancer patients who also have a learning disability (LD) have a one in nine chance of dying, compared to a one in 36 chance for testicular cancer patients without LD. This is because patients with LD are less likely to detect the disease at an earlier stage.

U2 - 10.1016/j.euo.2018.12.008

DO - 10.1016/j.euo.2018.12.008

M3 - Article

C2 - 31411979

SN - 2588-9311

VL - 3

SP - 773

EP - 779

JO - European Urology Oncology

JF - European Urology Oncology

IS - 6

ER -

Do learning disabilities affect testicular cancer survival: a national cohort study between 2001 and 2015

Abstract

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