The effect of patient's delay and doctor's delay in patients with malignant germ cell tumours.

In 103 patients with malignant germ cell tumours the initial clinical diagnosis was incorrect in 45 (44%). The correct diagnosis was established within 2 months in only 31% of the patients, and delayed by more than 6 months in 27%. Stage, distribution and survival were correlated with the histology, but not with the duration of symptoms or the patient's/doctor's delay. Rapidly growing tumours often belonged to the non-seminornaious group where advanced tumour stages and low survival rates were more common than in the seminoma group. The overall prognosis of patients with malignant germ cell tumours may be increased by an early diagnosis of testicular tumours in non-symptomatic patients, especially in men with possible risk factors (cryptorchidism, atrophic testis, antecedent contralateral testicular cancer).