Could deprivation account for the relatively good recruitment from the west of Scotland into NCRN Testis Clinical Studies Group poor prognosis trials?


Year:

Session type:

Cicely Cunningham1, Sharon Armstrong2, Ashita Waterston1, Nicola Thomson1, David Morrison1, Jeff White1
1The Beatson West of Scotland Cancer Centre, Glasgow, UK, 2Tayside Canccer Centre, Ninewells Hospital, Dundee, UK

Background

Germ cell tumours are the most common cancer affecting young men in the UK and generally carry a good prognosis. However, a sub-group, comprising 14 per cent of cases according to international data, have disease which carries a poorer prognosis, with less than 50 per cent alive at five years after diagnosis. In 2009, the TE23 trial recruited 89 patients in this group to compare CBOP/BEP with BEP1. Many centres struggled with recruitment, but the Beatson West of Scotland Cancer Centre (BWOSCC) was able to recruit a high proportion of the total (17%). This was consistent with previous audit data showing a higher proportion of poor prognosis presentations in the west of Scotland than would be expected from large series.

Method

This audit examined the caseload of the BWOSCC in one calendar year (from 1st July 2011 to 30th June 2012).

Results

As anticipated, a higher proportion of metastatic germ cell tumours (28 per cent/8 patients) presenting to our centre fell into the poor prognosis category, compared to 14 per cent expected from international data.There also appears to be an association between deprivation quintile (by postcode) and prognostic group, with half of the poor prognosis group living in the most deprived quintile, and a further 25 per cent living in the second most deprived quintile.

Conclusion

The apparent association between deprivation and prognostic group on presentation, demonstrated for the first time in our current analysis, would appear consistent with the latest data from the Scottish Cancer Registry, which shows a statistically significant relationship between mortality from testicular cancer and deprivation quintile. There may be an opportunity for targeted awareness raising amongst those working in primary care in the most deprived areas.