Date of Conferral

8-22-2024

Date of Award

August 2024

Degree

Ph.D.

School

Public Health

Advisor

Hadi Danawi

Abstract

Testicular cancer is the most common solid tumor among male young adults between 15 to 34 years old. Despite progress with the testicular cancer survival rate, American Indians or Alaskan Natives (AI/ANs) have the highest mortality rate of testicular cancer compared to all other racial groups in the United States. There is a shortage of reported studies on social-related factors that affect the survival rate of testicular cancer patients among AI/ANs. The purpose of this study was to examine the association between stage at diagnosis, treatment, insurance status, and marital status as independent variables and the survival rate (in months) among AI/AN testicular cancer patients aged 15 to 34 years in Alaska as dependent variables. The social-ecological model was used to guide this study. Using secondary data obtained from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, the retrospective cohort study included 196 Native Alaskan testicular cancer patients diagnosed between 2010 and 2018. Variables associated with the outcomes of interest were examined using survival analysis. The only stage at diagnosis was associated with the survival rate among AI/AN testicular cancer patients [HR = 0.329 (95% CI 0.121 - 0.894), p = 0.029]. There were no statistically significant associations between treatment and survival rate among AI/AN testicular cancer patients [HR = 2.972 (95% CI 0.378- 23.371), p = 0.301], and marital status and survival rate among AI/AN testicular cancer patients [HR = 0,289 (95% CI 0.065-1.273), p = 0.101]. The results of this study could be used to create positive social change by developing interventions to mitigate the health disparity that negatively affects AI/AN testicular cancer patients.

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