TY - JOUR
T1 - Disparities in Pre-Orchiectomy Sperm Cryopreservation Among Testicular Cancer Patients at a Public Safety Net Hospital and a Private Tertiary Care Center
AU - Patel, Akshat
AU - Howard, Jeffrey M.
AU - Chertack, Nathan
AU - Badia, Rohit R.
AU - Margulis, Vitaly
AU - Woldu, Solomon L.
AU - Courtney, Kevin
AU - Bowman, I. Alex
AU - Arafat, Waddah
AU - Meng, Xiaosong
AU - Bakare, Tolulope
AU - Bagrodia, Aditya
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - 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.
AB - 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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U2 - 10.1016/j.urology.2021.05.097
DO - 10.1016/j.urology.2021.05.097
M3 - Article
C2 - 34343562
AN - SCOPUS:85114696074
SN - 0090-4295
VL - 163
SP - 126
EP - 131
JO - Urology
JF - Urology
ER -