USPSTF Testicular Examination Nomination-Self-Examinations and Examinations in a Clinical Setting

Humor-Based Messaging in Testicular Cancer Awareness Campaigns: A Comparative Critical Review

Extensive research showcases the extent and efficacy of humor-based messaging in general health promotion. However, the work describing humor's use within testicular cancer (TC) awareness is less developed. The aim of this comparative critical review was to determine the impact of using humor-based messaging in TC awareness campaigns to achieve a baseline assessment from which future research can be modeled. A literature search was conducted using seven databases to locate relevant literature. Three research questions guided this investigation: (1) To what extent has humor been used in TC awareness campaigns? (2) What does the literature reveal about the use of humor-based messaging on relevant health outcomes? (3) What are the limitations within current TC awareness strategies? Six studies were included in the review, of which three directly assessed the use of humor in TC awareness vis-à-vis intervention designs. Humor-based strategies were implemented to enhance knowledge of TC and testicular self-examination (TSE) procedures, reduce anxiety surrounding detection threat, and promote TSE. The rhetoric provided to men via various health interventions relied on humor and slang to promote TSE among males. Despite the small sample size of the included studies, this review determined that humor may be useful in reducing uncomfortable feelings surrounding TSE, increasing awareness of TC, and promoting TSE. When using humor-based messaging, however, the audience and type of humor implemented must be considered. Limited research exists assessing the long-term impact humor in TC promotion on health behavioral changes, easing anxieties related to detection, and increased self-efficacy surrounding TSE.

Perceptions of testicular cancer and self-examination in the general population of Saudi Arabia

Background

Although testicular cancer (TC) is the most common malignancy in males between the ages of 18 and 50 years, little effort has been made to increase public awareness about TC and testicular self-examinations (TSEs). Therefore, the aim of this study was to assess the level of awareness of TC and TSEs in the Saudi population.

Materials and Methods

This study was conducted using a structured questionnaire distributed online through social media platforms. The questionnaire consisted of 11 questions related to TC and TSE. All relevant data were moved into an Excel sheet, and data analyses were carried out using SPSS.

Results

A total of 849 responses were received. The proportion of respondents who knew any information about TC was 26.5%, with media or the Internet being the most common sources of information (16.3%). In addition, 5.5% of respondents knew how to perform a TSE, although only 4% actually performed TSEs. The patient age group was an independent significant predictor of this knowledge, with a P = 0.031.

Conclusions

These findings suggest that there is a low level of public awareness and knowledge of TC and TSE in Saudi Arabia, and further efforts should be focused on raising public awareness.

Novel approaches to redesign surveillance strategies following orchiectomy for localized testicular cancer: a narrative review

Background and Objective

Surveillance is the preferred management strategy for most men with clinical stage I testicular cancer after orchiectomy. However, frequent office visits, imaging tests, and laboratory studies place a significant burden on patients, which may contribute to poor compliance with guideline-recommended surveillance regimens. Identifying strategies to overcome these barriers may help improve quality of life, reduce costs, and improve adherence for patients. We reviewed evidence for three strategies that may help with surveillance redesign: telemedicine, implementing microRNA (miRNA) as a biomarker, and novel imaging protocols.

Methods

A web-based literature search for novel imaging strategies, diagnostic utility of miRNA, and telehealth as they relate to early-stage testicular germ cell cancer was completed during the month of August 2022. We focused our search on contemporary PubMed-indexed and Google Scholar-registered manuscripts written in English. Supportive data sourced from current guideline statements were also included. Evidence was compiled for narrative review.

Key Content and Findings

Telemedicine is a safe and acceptable platform for urologic cancer follow-up care, but it requires further study specifically among men with testicular cancer. Access to care may either be improved or reduced depending on system- and patient-level characteristics and should be implemented with this in mind. miRNA may potentially be a helpful biomarker for men with localized disease, but further research on diagnostic accuracy and marker kinetics are needed before implementing it into routine surveillance strategies or using it to deviate from long-standing surveillance regiments. Novel imaging strategies with less frequent imaging and the use of magnetic resonance imaging (MRI) instead of computed tomography (CT) appear to be non-inferior in clinical trials. However, use of MRI requires expert radiologist availability and may be more costly with a lower ability to detect small, early recurrences when used in routine practice.

Conclusions

Using telemedicine, integrating miRNA as a tumor marker, and adopting less intensive imaging strategies may improve guideline-concordant surveillance for men with localized testicular cancer. Future studies are needed to assess the risks and benefits of using these novel approaches separately or together.

The effects of flipped classroom model on knowledge, behaviour and health beliefs on testicular cancer and self-examination: a randomized controlled trial study

This randomized controlled trial study aims to examine the flipped classroom model's effects on the knowledge and health beliefs of testicular cancer and testicular self-examination. The study was conducted on 66 students in Northern Cyprus. A descriptive information form, Champion's Health Belief Model Scale, visual analogue scale of satisfaction with the learning method, the knowledge questionnaire on testicular cancer and the testicular self-examination itself were used for data collection. The mean posttest knowledge score of the intervention group (14.44) was higher than the mean posttest knowledge score of the control group (12.65). The difference between groups was statistically significant (P < 0.05). The mean posttest scores obtained by the intervention group from the barriers and the severity subscales of the Champion's Health Belief Model Scale were lower than for the control group (P < 0.05). The percentages of participants performing the testicular self-examination after receiving training were 82.4% and 59.4% for the intervention group and control group, respectively. The complete trial protocol can be accessed at ClinicalTrials.gov (NCT04851197). Since the flipped classroom model increased the rate of students performing testicular self-exams and the levels of knowledge and satisfaction of the students, the use of this model in different courses may be promoted.

Testicular self-examination for early detection of testicular cancer

Testicular cancer (TCa) commonly presents as a painless scrotal mass. It has been suggested that testicular self-examination (TSE) can help in early detection and thus potentially improve treatment outcomes and prognosis. While TSE is more well established in guideline recommendations for patients with a known history of TCa, its role in healthy young men is less established and controversial. In this paper, we review contemporary data to provide an updated recommendation.

Awareness and Performance of Testicular Self-Examinations: An Analysis of Social and Cultural Barriers to Cancer Screenings in a US Orthodox Jewish Community

This study assessed barriers to testicular self-examination (TSE) performance in a population of US Modern Orthodox Jewish undergraduate students. Participants answered questionnaires that measured their TSE performance and their attitudes toward TSEs. Out of 541 participants, 301 (55.6%) had heard of TSEs, 177 (32.7%) had ever performed a TSE, and 21 (3.9%) performed TSEs once per month in the past year. Significant positive associations of TSE awareness and practice included self-efficacy and engagement with medical professionals vis-à-vis testicular health. Shame and adherence to certain religious beliefs negatively correlated with awareness and performance of TSEs. The results demonstrate medical professionals' integral role in educating young individuals about TSEs.

A Call to Action to Review the USPSTF's Recommendation for Testicular Self-Examination

We urge the United States Preventive Services Task Force (USPSTF) to call for a formal review of the evidence regarding testicular self-examination (TSE). Twelve years have since passed since the evidence was last formally analyzed where normally re-reviews occur in 5-year cycles. If they would decide to move forward with this action, we ask for the USPSTF to review their methods for establishing recommendations to optimize their rating system operationalization process. Finally, emerging evidence demonstrates a net positive effect of TSE. This stands in contrast to the assertions of TSE's supposed harm that is prevalent in the literature as well as the rationale behind the USPSTF's "D" rating of TSE.

A Cross-Sectional Analysis of Testicular Cancer Symptom Recognition and Stage of Diagnosis

There is a need to further explore the relationship between atypical symptom reporting and stage diagnosis to help develop a clearer defined list of possible testicular cancer (TC) symptoms that could assist physicians diagnose the disease earlier. A cross-sectional study was employed to explore possible associations between TC symptom presentation and stage of diagnosis. An original 40-item survey was distributed among 698 TC survivors to determine the potential impact of several risk factors, experiences, and behaviors upon diagnosis. This analysis aimed to explore how certain patient-driven experiences (e.g., symptoms, perceptions, and behaviors) could serve as catalysts for seeking medical care for testicular health concerns. Experiencing hot flashes or having no symptoms had a positive association with later-stage diagnosis while change in shape had a significant negative association with later-stage diagnosis. While the logistic regression model explained relatively low variance in the data (R² = .1415), it was statistically significant (χ²p < .001). Pain (odds ratio [OR] = 1.6524, p < .05), hot flashes (OR = 5.7893, p < .01), and no symptoms experienced (OR = 12.4836, p < .01) were all significant predictors of a more advanced stage diagnosis. The concern around uncommon/atypical symptoms are that they are indistinct and do not serve as clear signs that TC is present. However, perhaps in tandem with other more overt symptoms, their discovery can serve in a more confirmatory role for a suspect case. If observed with other uncommonly reported symptoms, these uncommon symptoms could provide another pathway in the TC diagnostic process. Clinical and patient education is warranted to increase awareness of uncommon TC symptoms.

The Association Between Testicular Self-Examination and Stages of Testicular Cancer Diagnosis: A Cross-Sectional Analysis

Purpose: Testicular cancer (TC) is the most prevalent tumor diagnosed in men 15-40 years of age. Survivorship and quality of life dramatically decrease with late-stage diagnosis. Testicular self-examination (TSE) is a diagnostic method used to discover early-stage tumor incidence. This study examines the relationship between practicing TSE and stage of diagnosis for TC survivors. Methods: A cross-sectional study design was employed, a 40-item survey among TC survivors (n = 619). Bivariate analyses consisted of Spearman Rho correlations of all primary variables with stage diagnosis of TC. Multivariate analysis employed an ordered logistic regression to determine stage diagnosis predictors. Results: "Regular" TSE practice significantly related with awareness (r = 0.4533) and knowledge of (r = 0.4866) TSE, confidence performing TSE (r = 0.4961), and feeling shape/feel differences of the testicle before diagnosis (r = 0.2115). Factors that had a statistically significant negative association with later-stage diagnosis included awareness (r = -0.1180) and knowledge of (r = -0.1586) TSE, confidence performing TSE (r = -0.1138), and feeling shape/feel differences of the testicle before diagnosis (r = -0.2938), among others. Regular TSE practice significantly predicted decreased odds of later-stage diagnosis within the sample subset reporting delay (odds ratio = 0.1628; p < 0.05); however, there was no significant relationship between regular TSE practice and stage diagnosis within the other model variations. Conclusion: This exploratory analysis aimed to provide baseline evidence of the possible association between the practice of TSE and the stage of TC diagnosis, and therefore making an indirect claim that TSE has the potential to improve quality of life and decrease TC mortality, particularly among adolescents and young adults.

Attitudes about Testicular Self-Examination among Polish Males

Simple Summary

Testicular cancer (TC) affects men at a young age and has high survival rates. Most TCs are detected as palpable masses during self-examination (TSE) or physical examinations performed by General Practitioner (GP). The aim of the study was to discover the attitudes among Polish males regarding TSE and factors (environmental, social, educational) that affect intention to perform TSE. The mean age of the surveyed respondents was 32 years. Information about TC and how to perform TSE was obtained by 34.4% (n = 185) of the men. It was shown that the following factors increase men’s intention to perform TSE: TC in their family member (p < 0.05; HR = 5.9; 95% CI: 1.5–23.0), GP’s recommendations (p < 0.001; HR = 6.8; 95% CI: 3.2–14.3), concern expressed by their partner (p < 0.001; HR = 3.3; 95% CI: 2.1–5.3), and social campaigns (p < 0.001; HR = 2.6; 95% CI: 1.5–4.6). Approximately half of young polish males do not perform TSE. Access to information on TC prevention is limited. Teaching TSE will result in these men taking increased responsibility for their own healthcare.

Abstract

Introduction: Epidemiological data indicate an increased incidence of testicular cancer (TC), making it the most common malignant tumor in men from aged 15–45. Oncological and urological associations recommend that men with specific TC risk factors should regularly perform a testicular self-exam (TSE). The aim of the study was to discover the attitudes among Polish males regarding TSE and factors (environmental, social, educational) that affect intention to perform TSE. Methods: An original survey containing 21 questions was used to conduct a study among the Polish branch of VW (Volkswagen Poland) employees. Results: A total of 522 fully completed questionnaires were collected. The mean age of the surveyed respondents was 32 years. Information about TC and how to perform TSE was obtained by 34.4% (n = 185) of the men. It was shown that the following factors increase men’s intention to perform TSE: TC in their family member (p < 0.05; HR = 5.9; 95% CI: 1.5–23.0), GP’s(General Practitioner) recommendations (p < 0.001; HR = 6.8; 95% CI: 3.2–14.3), concern expressed by their partner (p < 0.001; HR = 3.3; 95% CI: 2.1–5.3), and social campaigns (p < 0.001; HR = 2.6; 95% CI: 1.5–4.6). Conclusions: Approximately half of young polish males do not perform TSE. Access to information on TC prevention is limited. Further action is needed to improve men’s awareness of TC and TSE.

Screening for cancers with a good prognosis: The case of testicular germ cell cancer

Background

To determine, using testicular germ cell cancer screening as an example, whether screening can also be effective for cancers with a good prognosis.

Methods

Based on the Dutch incidence, stage distribution, and survival and mortality data of testicular germ cell cancer, we developed a microsimulation model. This model simulates screening scenarios varying in screening age, interval, self‐examination or screening by the general practitioner (GP), and screening of a defined high‐risk group (cryptorchidism). For each scenario, the number of clinically and screen‐detected cancers by stage, referrals, testicular germ cell cancer deaths, and life‐years gained were projected.

Results

Annual self‐examination from age 20 to 30 years resulted in 767 cancers detected per 100,000 men followed over life‐time, of which 123 (16%) by screening. In this scenario, 19.2 men died from the disease, 4.7 (20%) less than without screening, and 230 life‐years were gained. Around 14,000 visits to the GP and 2080 visits to an urologist were required. This scenario resulted in the most favorable ratio between extra visits to the GP or urologist and deaths prevented (1418 and 116 respectively). Monthly screening, or screening until age 40 resulted in less favorable ratios. Self‐examination by only the high‐risk population prevented 1.0 death per 100,00 men in the general population. In all scenarios, 46–50 life‐years were gained for each testicular germ cell cancer death prevented.

Conclusion

Despite the good prognosis, self‐examination at young ages for testicular germ cell cancer could be considered.

[Testicular and breast self-examination-a retrospective cohort study of medical students]

Hintergrund

Durch eine regelmäßige Selbstuntersuchung kann ein Malignom der Hoden oder Brust gegebenenfalls frühzeitig erkannt und kurativ behandelt werden. Ziel dieser Arbeit war es, das Selbstuntersuchungsverhalten von Medizinstudierenden zu untersuchen und Faktoren, die eine regelmäßige Selbstuntersuchung beeinflussen, zu identifizieren.

Methodik

Medizinstudierende wurden mittels Fragebogen bezüglich ihres Gesundheits- und Sexualverhaltens befragt. 98,8 % der Studierenden nahmen teil (n = 473). Die erhobenen Daten wurden mittels univariater und multivariater logistischer Regression analysiert.

Ergebnisse

Es gaben 64,2 % der männlichen Studierenden (n = 177) an, regelmäßig ihre Hoden zu untersuchen und 72,2 % der weiblichen Studierenden (n = 296) gaben an, regelmäßig ihre Brust abzutasten. Studierende, die nicht mit ihrer/ihrem PartnerIn bzw. mit ihren FreundInnen über ihre Sexualität sprechen, führten seltener eine Selbstuntersuchung durch (p < 0,05). Männliche Studierende, die in den letzten 4 Wochen vor Befragung keinen Geschlechtsverkehr hatten und weibliche Studierende, die im gleichen Zeitraum nicht masturbierten, führten seltener eine Selbstuntersuchung durch (p < 0,05).

Diskussion

Der Anteil an Medizinstudierenden, der eine regelmäßige Selbstuntersuchung durchführt, ist im Vergleich zu weniger medizinisch gebildeten jungen Erwachsenen hoch. Wissen über die Relevanz von Hoden- bzw. Brustkrebs scheint grundlegend für eine regelmäßige Selbstuntersuchung zu sein. Ein belastetes Sexualleben schränkt solch ein Gesundheitsverhalten möglicherweise ein. Eine Verbesserung der Aufklärung über Hodenkrebs und die urologische Anbindung von Jungen/junger Männer bieten daher die Möglichkeit, die Bereitschaft zur Selbstuntersuchung innerhalb dieser Altersgruppe zu steigern.

Cancer education matters: a report on testicular cancer knowledge, awareness, and self-examination practice among young Polish men

The objective of the study was to assess the level of testicular cancer (TC) knowledge and awareness as well as the altitude and practice towards testicular self-examination (TSE) among Polish male high school and medical students. An original questionnaire survey was conducted in SE Poland with a representative sample of 1077 male students: 335 from high school and 742 medical students. The results indicate the knowledge about TC epidemiology and the awareness of risk factors responsible for the TC was low. The knowledge of the signs and symptoms of TC was significantly higher among the medical students, compared to the high school students. The level of education was associated with the awareness of methods for early detection and symptoms of TC. A satisfactory level of awareness of the TSE practice was exhibited only by the medical students. The main reason for not performing self-examination was the lack of knowledge and practical skills. The deficits of knowledge of TC in young men should motivate the education policy makers in Poland to implement education in the field of TC issues more widely in high schools. Moreover, cancer prevention modules and/or teaching methods should be improved in medical schools.

[Awareness of clinical relevance of malignant testicular cancer among university students : The value of ​prevention campaigns]

BACKGROUND

Early detection of localized testicular cancer is associated with a significantly better prognosis compared to advanced tumor stages. Testicular cancer prevention campaigns like "Hodencheck.de" launched by the German Society of Urology or the international campaign "Movember Foundation" want to inform and raise awareness about testicular cancer and other male cancers. This study aimed to evaluate to which extent public prevention campaigns may influence the behavior of young men and women in Germany.

OBJECTIVES

Questionnaires were used to ask students at the University of Frankfurt, Germany, whether they are familiar with the currently most widespread testicular cancer prevention campaigns and whether testicular examinations for cancer screening were performed by themselves, a partner or a physician.

RESULTS

Only a minority of the students were aware of the testicular cancer prevention campaigns "Hodencheck.de" and/or "Movember Foundation"; 79.9% of the male and 83.6% of female students had not heard of the two mentioned prevention campaigns. Significantly more male (35.2%) compared to female students (28.9%) knew that testicular cancer is the most common cancer in young men. Of the men, 48.9% had already palpated their testicles, while only 12.4% of the women had already palpated the partner's testicles for cancer screening. Students knowing about the testicular cancer prevention campaigns performed significantly more testicular examinations for screening purposes.

CONCLUSIONS

Our study demonstrates that current testicular cancer prevention campaigns are little known amongst German university students. However, the knowledge of testicular cancer prevention campaigns resulted in an increased awareness and an increased willingness for testicular (self-) examinations.

Testicular Cancer at the University of Port Harcourt Teaching Hospital: A 10-year Retrospective Review

BACKGROUND

Testicular cancers are rare malignancies. They are however very common in males aged 15-40 years. Reports of increasing incidence of testicular cancer in western countries have been noted. Despite the increasing incidence, mortality has remained low in these countries. There are few publications on the management of testicular tumors in Nigeria.

AIM

The aim of this study was to determine the hospital prevalence and highlight our experience in the management of patients with testicular cancer.

MATERIALS AND METHODS

This was a 10-year retrospective study on patients diagnosed with histologically confirmed testicular cancer from January 2009 to December 2018. The case records were retrieved. Data obtained included biodata, clinical presentation, investigations, treatment received and outcomes. Data analysis was carried out using SPSS version 20.0.

RESULTS

Eleven patients with testicular cancer were managed during the study period, constituting 0.01% of new cases seen in the hospital. Peak age was 20-29 years (54.55%), with a mean age of 29.27 ± 9.51yrs. The most common presentation was painless scrotal swelling, observed in nine (81.8%) patients. Nine (81.8%) patients presented six months or more after onset of symptoms with advanced disease. Distant metastasis was seen in two (18.2%) patients. Right sided disease was found in seven (63.6%) and left sided disease in four (36.4%). All had radical inguinal orchidectomy. The most common histological diagnosis was seminoma in 8 (72.7%) patients. All the subjects were offered four courses of chemotherapy with bleomycin, etoposide and cisplatin. However, only four (36.4%) completed the chemotherapy. A statistically significant association was observed between the duration of symptoms and the disease stage (P = 0.003), and between number of chemotherapy sessions and survival (P = 0.02).

CONCLUSION

Testicular cancer was an uncommon condition in the catchment area of the University of Port Harcourt Teaching Hospital, affecting relatively young men. The commonest presenting complaint was painless scrotal swelling. Most patients presented with Stage II disease, with seminoma being the commonest histopathology. All had surgical treatment; adjuvant chemotherapy improved 5-year survival. Public education is necessary to surmount sociocultural barriers to effective management of testicular tumors in our environment.