ABSTRACT
Objective
To compare pre-orchiectomy sperm cryopreservation use in testicular cancer patients
at a private tertiary care academic center and an affiliated public safety-net hospital.
Methods
This was a retrospective cohort study of patients who underwent radical orchiectomy
for testicular cancer at a private tertiary-care hospital, which cared primarily for
patients with private health insurance, and at a public “safety-net” facility, which
cared for patients regardless of insurance status. Clinical and demographic predictors
of cryopreservation use prior to orchiectomy were determined by chart review.
Results
A total of 201 patients formed the study cohort, 106 (53%) at the safety-net hospital
and 95 (47%) at the private hospital. Safety net patients were more likely to be non-White
(82% vs 15%, P < 0.001), uninsured (80% vs 12%, P < 0.001), Spanish speaking (38% vs 5.6%, P < 0.001), and to reside in areas in the bottom quartile of income (41% vs 5.6%, P < 0.001). On multivariable analysis, treatment at the private tertiary care center
was strongly associated with use of cryopreservation (OR 5.60, 95% CI 1.74 - 20.4,
P = 0.005, though the effects of specific demographic factors could not be elucidated
due to collinearity.
Conclusion
Among patients with testicular cancer, disparities exist in use of sperm cryopreservation
between the private and safety-net settings. Barriers to the use of cryopreservation
in the safety-net population should be sought and addressed.
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Article info
Publication history
Published online: August 02, 2021
Accepted:
May 3,
2021
Received:
February 9,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
