Adams Wesley B, Rovito Michael J, Craycraft Mike
1 Behavioral Health Research Group, College of Health and Public Affairs, Department of Health Professions, University of Central Florida, Orlando, FL, USA.
2 Testicular Cancer Society, Cincinnati, OH, USA.
Am J Mens Health. 2018 Sep;12(5):1774-1783. doi: 10.1177/1557988318786874. Epub 2018 Jul 16.
Testicular cancer (TCa) is the most prevalent neoplasm diagnosed in males aged 15-40 years. Lack of access to care is a key impediment to early-stage TCa diagnosis. Health equity concerns arise, however, as poor access largely manifests within underserved male populations, therefore, placing them at a higher risk to develop late-stage TCa. Planned Parenthood Federation of America (PPFA) offers a myriad of male reproductive/sexual health care options, including TCa screening and referral services. Therefore, expanding these amenities in traditionally underserved communities may address the concern of TCa screening opportunities. An ecological analysis was performed using data from the United States Cancer Statistics, American Community Survey, and PPFA databases to assess the impact of TCa upon minority males, identify associations between PPFA services and minority males, and provide future implications on the role PPFA may play in bridging health-care access gaps pertaining to TCa screenings. Results indicate that states with higher rates of poverty and uninsured individuals, as well as specifically Black/African American males, have lower TCa incidence and limited access to screening services. PPFA service presence and Black/African American, as well as uninsured, males had a negative association but revealed positive correlations with TCa incidence. Considering the emerging TCa outcome disparities among minority males, expanding PPFA men's health services is crucial in providing affordable options to help identify testicular abnormalities that are early stage or carcinoma in situ. Many at-risk males have limited means to obtain TCa screening services. Expanding this discussion could provide a foundation for future advocacy.
睾丸癌（TCa）是15至40岁男性中最常见的肿瘤。难以获得医疗服务是早期TCa诊断的关键障碍。然而，由于难以获得医疗服务的情况主要在服务不足的男性人群中出现，因此引发了健康公平问题，这使得他们患晚期TCa的风险更高。美国计划生育联合会（PPFA）提供了众多男性生殖/性健康护理选择，包括TCa筛查和转诊服务。因此，在传统上服务不足的社区扩大这些便利设施可能会解决TCa筛查机会的问题。利用美国癌症统计数据、美国社区调查和PPFA数据库进行了一项生态分析，以评估TCa对少数族裔男性的影响，确定PPFA服务与少数族裔男性之间的关联，并对PPFA在弥合与TCa筛查相关的医疗服务获取差距方面可能发挥的作用提供未来启示。结果表明，贫困率和未参保率较高的州，以及特别是黑人/非裔美国男性，TCa发病率较低且获得筛查服务的机会有限。PPFA服务的存在与黑人/非裔美国男性以及未参保男性呈负相关，但与TCa发病率呈正相关。考虑到少数族裔男性中出现的TCa结果差异，扩大PPFA的男性健康服务对于提供负担得起的选择以帮助识别早期或原位癌的睾丸异常至关重要。许多高危男性获得TCa筛查服务的途径有限。扩大这一讨论可为未来的宣传提供基础。
