title: Quality of life among testicular cancer survivors: a case-control study in the United States.
abstract: BACKGROUND
  Evidence from previous studies has suggested there may be physical and mental changes in health among testicular cancer survivors. No studies have been conducted in the United States, however.
  
  
  METHODS
  Study participants were initially enrolled in the US Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) study between 2002 and 2005. A total of 246 TGCT (testicular germ cell tumor) cases and 236 non-testicular cancer controls participated in the current study, and completed a self-administered questionnaire. Mean time since diagnosis for cases was 14 years, and no less than five for all cases. Component scores determined from responses to questions about physical and mental health on SF36 were tabulated to yield two summary measures, physical component scores (PCS), and mental component scores (MCS). Component and summary scores were normalized to a score of 50 with a standard deviation of 10 by a linear T-score transformation.
  
  
  RESULTS
  Overall, cases may not suffer greatly in different quality of life than controls. When all cases and controls are compared, TGCT cases had lower PCS (mean: 51.9 95% CI: 50.6-53.2, P value: 0.037) than controls (mean: 53.6 95% CI: 52.7-54.6). MCS were not significantly different (P value: 0.091). In multivariate analyses, several physical health components were worse for TGCT cases such as role-physical (OR 1.19, 95% CI: 1.01-1.39) and general health (OR 1.26, 95% CI: 1.07-1.49) compared to controls. However, TGCT cases treated with chemotherapy had lower PCS (cases: 50.2, 95% CI: 47.6-52.8; controls: 53.6, 95% CI: 52.7-54.6, P value: 0.0032) and MCS (cases: 49.3, 95% CI: 46.5-52.1; controls: 52.0, 95% CI: 50.9-53.2, P value: 0.039). TGCT cases who received treatments other than chemotherapy did not differ from controls in either PCS or MCS.
  
  
  CONCLUSIONS
  Physical and general health limitations may affect testicular cancer survivors. Men treated with chemotherapy, however, may be most likely to suffer adverse health outcomes due to a combination of body-wide effects on physical and mental factors which affect various aspects of physical health, mental health, and overall quality of life. And in particular, physical functioning, role-physical, and general health are strongly affected.
authors.affiliation: Yale School of Public Health, Yale University, 60 College Street, LEPH 440, New Haven, CT 06520, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kim
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Erickson
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
authors.forename: Shuangge
authors.initials: S
authors.lastname: Ma
authors.forename: Barry
authors.initials: B
authors.lastname: Graubard
authors.forename: Briseis
authors.initials: B
authors.lastname: Aschebrook-Kilfoy
authors.forename: Kathryn Hughes
authors.initials: KH
authors.lastname: Barry
authors.forename: Yawei
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011788:Quality of Life / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy; D014481:United States; D055815:Young Adult