Increasing incidence of testicular cancer in blacks

Testicular self-examination in young adult men

PURPOSE

To describe patterns of testicular self-examination (TSE) in a sample of young adult men and to identify factors distinguishing between men who do and do not practice TSE.

DESIGN

A comparative descriptive design with a convenience sample of 191 adult men aged 18-35 years, recruited from a large industrial complex in the U.S. Midwest. Data were collected during several occupational health fairs held from 1999-2001.

METHODS

A self-report, 75-item health risk appraisal (HRA) was administered to identify health-related lifestyle habits. Men who did and did not perform TSE regularly were compared using Mann-Whitney U statistics for discrete variables and t tests for continuous data. Discriminant function analysis was used to identify factors allowing prediction of frequent or infrequent TSE performance.

FINDINGS

Sixty-four percent of 191 participants reported rarely or never performing TSE, and 36% practiced TSE monthly or every few months. Men who infrequently performed TSE were more often African American or Hispanic and had less than a college education. Other significant factors associated with infrequent TSE practice included less satisfaction with current job assignment; less satisfaction with life in general; greater worries interfering with daily life; more serious family problems in dealing with spouse, children, or parents; and reduced availability of people to turn to for support.

CONCLUSIONS

Demographic and socioeconomic variables were related to TSE knowledge and performance. Further investigation is required to determine why men, especially ethnic minority men, are not performing this important cancer-screening activity.

Testicular cancer in blacks. A multicenter experience

BACKGROUND

The rarity of testis tumor in black patients has made the study of a large series difficult. Much of the epidemiologic and clinical information regarding this neoplasm in this population is in dispute, including data on incidence, prognosis, histologic distribution, age and stage at presentation, and side distribution.

METHODS

A retrospective review of 66 blacks with testicular tumors from seven military medical centers was performed.

RESULTS

Similar results were found for blacks with testis tumor to those of the general testis cancer population regarding prognosis, side distribution, and age of onset for nonseminoma and interstitial tumors. There is a slight increase in the expected number of interstitial tumors in blacks, but the distribution between seminoma and nonseminoma is similar to the general population. The mean age of presentation for seminoma in blacks was younger than that of the general testis cancer population. For testis tumor treated at the same institution, there was an increased delay of diagnosis in blacks compared with whites. The number of new cases of testicular cancer between 1979 and 1991 at one major center was increased for whites but not for blacks. The availability of cisplatin-based combination chemotherapy has resulted in an improved prognosis for blacks, as has already been demonstrated for white populations.

CONCLUSIONS

Testis tumor in blacks behaves similarly to testis tumor in the general population except that in blacks there are more interstitial tumors and the mean age of presentation for seminoma is younger. Further, there is an increased delay in diagnosis for blacks compared with whites, but the incidence of this tumor in this population does not appear to be increasing. Cisplatin-based chemotherapy has significantly improved survival in this population.

Health education for testicular cancer

The incidence of testicular cancer is rapidly increasing. It is highly curable when detected and treated early, yet 500 to 1,000 men die from this cancer each year. Most victims are young men whose deaths account for a large number of potential years of life lost. Risk factors for testicular cancer are known but they cannot account for the increase in incidence. Only one age group, men between 15 and 34 years, is currently exhibiting an increase in incidence and mortality and should therefore comprise the primary at-risk group. Health education for the at-risk group, including promotion of regular and accurate testicular self-examination (TSE), could lead to earlier tumor detection and treatment and thereby save lives.

Self-report and medical record report agreement of selected medical conditions in the elderly

This study assessed agreement between self- and medical record report of medical conditions in an elderly population. Medical charts of 120 participants in a screening program were abstracted, and the questionnaire report of eight major conditions was compared with the medical record. There was substantial or moderate agreement between self-report and medical record report for each condition, although strength of agreement varied by condition. Self-report by elderly individuals compares favorably with medical record report of medical conditions.

Is testicular cancer incidence in blacks increasing?

Using data collected by the Surveillance, Epidemiology and End Results Program (SEER) from 1973-84, we found no evidence of an increase in the incidence of testicular cancer in Blacks, in contrast to an increase of nearly 33 percent in Whites.