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Saab MM, McCarthy M, Davoren MP, Shiely F, Harrington JM, Shorter GW, Murphy D, O’Mahony B, Cooke E, Murphy A, Kirby A, Rovito MJ, Robertson S, FitzGerald S, O’Connor A, O’Riordan M, Hegarty J, Dahly D. Enhancing Men's Awareness of Testicular Diseases (E-MAT) using virtual reality: A randomised pilot feasibility study and mixed method process evaluation. PLoS One 2024; 19:e0307426. [PMID: 39037976 PMCID: PMC11262699 DOI: 10.1371/journal.pone.0307426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Testicular cancer is among the most common malignancies in men under the age of 50 years. Most testicular symptoms are linked to benign diseases. Men's awareness of testicular diseases and testicular self-examination behaviours are suboptimal. In this pilot feasibility study and process evaluation we examine the feasibility of conducting a future definitive randomised controlled trial (RCT) to test the effect of the Enhancing Men's Awareness of Testicular Diseases using Virtual Reality intervention (E-MATVR) compared to the Enhancing Men's Awareness of Testicular Diseases using Electric information control (E-MATE). The study protocol is registered on ClinicalTrials.gov (NCT05146466). METHODS Male athletes, engaged in Gaelic games, and aged 18 to 50 years were included. Recruitment was via FacebookTM, XTM (formerly TwitterTM), and posters. Participants were individually randomised to either E-MATVR or E-MATE. Data were collected at baseline (T0), immediately post-test (T1), and three months post-test (T2) using surveys. Qualitative interviews were conducted with participants and researchers. RESULTS Data were collected from 74 participants. Of those, 66 were retained. All E-MATVR participants and most E-MATE participants (n = 33, 89.2%) agreed/strongly agreed that the device was easy to use and that they were engaged to learn by the device. Most E-MATVR participants (n = 34, 91.9%) and all E-MATE participants agreed/strongly agreed that the time it took them to complete the intervention was reasonable. All 74 participants were extremely satisfied/somewhat satisfied with their overall participation in the study. E-MATVR was described as interactive, easy, fun, and close to real life. Initial difficulty using VR equipment, nausea, and technical issues were identified as challenges to engaging with E-MATVR. Recommendations were made to make VR more accessible, shorten the survey, and incorporate more interactivity. Across all participants, mean testicular knowledge scores (range 0-1) increased from 0.4 (SD 0.2) at T0 to 0.8 (SD 0.2) at T1. At T2, overall mean scores for participants were 0.7 (SD 0.2). Mean knowledge scores did not differ by trial arm at any timepoint. At T2, all E-MATVR participants and 29/32 E-MATE participants (90.6%) reported purposefully examining their testes within the past three months. CONCLUSION Findings are promising, highlighting the feasibility of using VR to promote young athletes' awareness of testicular diseases. Considering the strengths, limitations, and lessons learned from this study, some modifications are required prior to conducing an RCT. These include but are not limited to shortening survey questions, incorporating more interactivity and visual content, and targeting more heterogenous male-dominated environments.
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Affiliation(s)
- Mohamad M. Saab
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Megan McCarthy
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martin P. Davoren
- Sexual Health Centre, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Frances Shiely
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Janas M. Harrington
- School of Public Health, University College Cork, Cork, Ireland
- Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - David Murphy
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Billy O’Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
- Health Research Board National Clinical Trials Office, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Michael J. Rovito
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, United States of America
| | - Steve Robertson
- School of Allied Health Professions, Nursing & Midwifery, Faculty of Health, University of Sheffield, Sheffield, United Kingdom
| | - Serena FitzGerald
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Alan O’Connor
- St. Finbarr’s National Hurling & Football Club, Cork, Ireland
| | | | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
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Saab MM, Shetty VN, McCarthy M, Davoren MP, Flynn A, Kirby A, Robertson S, Shorter GW, Murphy D, Rovito MJ, Shiely F, Hegarty J. Codesign and Launch of 'On the Ball': An Inclusive Community-Based 'Testicular Awareness' Campaign. Health Expect 2024; 27:e14100. [PMID: 38872440 PMCID: PMC11176580 DOI: 10.1111/hex.14100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Increased awareness of testicular diseases can lead to early diagnosis. Evidence suggests that men's awareness of testicular diseases is low, with many expressing their willingness to delay help-seeking for symptoms of concern. The risk of testicular diseases is higher in gender and sexual minority groups. In this study, we discuss the codesign, refinement and launch of 'On the Ball', an inclusive community-based 'testicular awareness' campaign. METHODS The World Café participatory research methodology was used. Individuals from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, policymakers, media/marketing experts and graphic designers were recruited. Participants were handed a brief for 'On the Ball', which was designed based on feedback from a previous World Café workshop. They were assigned to three tables. Participants rotated tables at random for three 20-min rounds of conversations. Each table had a facilitator who focussed on one element of the campaign brief. Data were collected using audio recorders and in writing and were analysed thematically. RESULTS Thirteen individuals participated in the workshop. The following themes emerged from the data: (i) campaign identity, (ii) campaign delivery and (iii) campaign impact. Participants recommended enhancements to the campaign logo, slogan, social media posts and poster. They suggested delivering the campaign online via social media and offline using various print and broadcast media. Participants recommended targeting areas with a large number of men such as workplaces. To help measure the impact of the campaign, participants proposed capturing social media analytics and tracking statistics relating to testicular diseases. Recommendations were used to refine the 'On the Ball' campaign and launch it in a university. In total, 411 students engaged with the various elements of the campaign during the soft launch. CONCLUSIONS 'On the Ball' campaign visuals ought to be inclusive. Online and offline campaign delivery is warranted to reach out to a wider cohort. Campaign impact can be captured using social media analytics as well as measuring clinical outcomes relating to testicular diseases. Future research is needed to implement the campaign online and offline, explore its impact and evaluate its feasibility, acceptability, cost and effect on promoting testicular awareness. PATIENT OR PUBLIC CONTRIBUTION The 'On the Ball' campaign was codesigned and refined with members of Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policymakers, media and marketing experts and graphic designers using the World Café participatory research methodology.
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Affiliation(s)
- Mohamad M. Saab
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Varsha N. Shetty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Megan McCarthy
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Martin P. Davoren
- Sexual Health CentreCorkIreland
- School of Public HealthUniversity College CorkCorkIreland
| | - Angela Flynn
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Ann Kirby
- Department of Economics, Cork University Business SchoolUniversity College CorkCorkIreland
| | - Steve Robertson
- School of Allied Health Professions, Nursing & Midwifery, Faculty of HealthUniversity of SheffieldSheffieldUK
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of PsychologyQueen's University BelfastBelfastUK
| | - David Murphy
- School of Computer Science & Information TechnologyUniversity College CorkCorkIreland
| | - Michael J. Rovito
- Department of Health Sciences, College of Health Professions and SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Frances Shiely
- School of Public HealthUniversity College CorkCorkIreland
- HRB Clinical Research FacilityUniversity College CorkCorkIreland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
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Saab MM, Shetty VN, McCarthy M, Davoren MP, Flynn A, Kirby A, Robertson S, Shorter GW, Murphy D, Rovito MJ, Shiely F, Hegarty J. Promoting 'testicular awareness': Co-design of an inclusive campaign using the World Café Methodology. Health Expect 2024; 27:e13898. [PMID: 37877701 PMCID: PMC10726274 DOI: 10.1111/hex.13898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
INTRODUCTION Testicular cancer is the most common cancer in men aged 15-44 years in many countries. Most men with testicular cancer present with a lump. Testicular symptoms are more likely to occur secondary to benign diseases like epididymo-orchitis, a common sexually transmitted infection. Gender and sexual minorities are at an increased risk of testicular diseases and health disparities. The aim of this study was to co-design an inclusive community-based campaign to promote testicular awareness. METHODS This study uses the World Café methodology. Participation was sought from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. Participants engaged in three rounds of conversations to co-design the campaign. Data were collected using drawing sheets, artefact cards, sticky notes, coloured markers and a voice recorder. Deductive thematic analysis was conducted. RESULTS Seventeen individuals participated in the study. Six themes emerged from the analysis as follows: (i) online communication; (ii) offline communication; (iii) behavioural targeting and education; (iv) campaign frequency and reach; (v) demographic segmentation; and (vi) campaign identity. The use of social media for campaign delivery featured strongly in all conversations. Participants also recommended offline communication using posters and radio/television advertisements to scale up the campaign and achieve wider reach. Advertisements to overcome embarrassment surrounding testicular health were particularly recommended. Participants emphasised that campaign delivery must be dynamic whilst ensuring that the health-promoting messages are not diluted or lost. They stressed the importance of being inclusive and tailoring the campaign to different age groups, gender identities and sexual orientations. CONCLUSIONS Study recommendations will be used to design and deliver the campaign. Future research will be needed to evaluate the feasibility, acceptability, cost and effect of the campaign on promoting testicular awareness and early detection of testicular diseases. PATIENT OR PUBLIC CONTRIBUTION A participatory research approach was used to co-design the campaign with members of Lesbian, Gay, Bisexual, Transgender and Queer+ (LGBTQ+) friendly organisations, LGBTQ+ student bodies, LGBTQ+ staff networks, LGBTQ+ sports clubs, men's health organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers.
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Affiliation(s)
- Mohamad M. Saab
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Varsha N. Shetty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Megan McCarthy
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Martin P. Davoren
- Sexual Health CentreCorkIreland
- School of Public HealthUniversity College CorkCorkIreland
| | - Angela Flynn
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Ann Kirby
- Department of Economics, Cork University Business SchoolUniversity College CorkCorkIreland
| | - Steve Robertson
- School of Allied Health Professions, Nursing & Midwifery, Faculty of HealthUniversity of SheffieldSheffieldUK
| | | | - David Murphy
- School of Computer Science & Information TechnologyUniversity College CorkCorkIreland
| | - Michael J. Rovito
- Department of Health Sciences, College of Health Professions and SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Frances Shiely
- School of Public HealthUniversity College CorkCorkIreland
- HRB Clinical Research FacilityUniversity College CorkCorkIreland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
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Saab MM, Davoren MP, Murphy A, Murphy D, Cooke E, Landers M, Fitzgerald S, Richardson N, Rovito MJ, Von Wagner C, Murphy M, Dahly D, Hegarty J. Promoting men's awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions. HRB Open Res 2023; 1:16. [PMID: 32002508 PMCID: PMC6973532 DOI: 10.12688/hrbopenres.12837.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background: Testicular cancer (TC) is among the most commonly diagnosed cancers in men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders, such as testicular torsion and epididymitis, can lead to testicular ischemia, sepsis, and infertility if left untreated. This updated systematic review aims to evaluate the effectiveness of studies promoting men's knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular disorder symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsycINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, and Clinicaltrials.gov were searched for studies published between April 2018 and August 2023. Methodological quality was assessed and results were synthesised meta-narratively. Results: Five studies were included. The majority of the reviewed interventions were successful in increasing men's awareness of TC and self-examination, including a PowerPoint presentation, an online educational brochure, video-assisted teaching, a motivational video, and a virtual reality game. Only one study addressed help-seeking for testicular symptoms and promoted men's awareness of benign as well as malignant testicular diseases. Conclusions: This review highlights the importance of evaluating innovative educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular disorder symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The protocol of the previous version of this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.
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Affiliation(s)
- Mohamad M. Saab
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martin P. Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, University College Cork, Cork, Ireland
| | - David Murphy
- School of Computer Science & Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
- Health Research Board National Clinical Trials Office, College of Medicine & Health, University College Cork, Cork, Ireland
| | - Margaret Landers
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Serena Fitzgerald
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Noel Richardson
- Department of Science and Health, South East Technological University, Carlow, Ireland
| | - Michael J. Rovito
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Christian Von Wagner
- Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, UK
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Hegarty J, McCarthy M, Davoren M, Shiely F, Harrington JM, Shorter G, Murphy D, Cooke E, O'Mahony B, M. Saab M. Enhancing men's awareness of testicular diseases (E-MAT) feasibility trial: Protocol for a mixed method process evaluation. HRB Open Res 2023; 5:25. [PMID: 37636246 PMCID: PMC10450256 DOI: 10.12688/hrbopenres.13515.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 08/29/2023] Open
Abstract
Background: Testicular cancer (TC) is the most common malignancy in men under 50 years. Athletes are particularly at risk of testicular trauma and diseases. Experiencing negative testicular symptoms does not necessarily imply that men seek help. Men's awareness of testicular diseases is often lacking and their intention to seek help for testicular symptoms is sub-optimal. The use of virtual reality (VR) may be effective in promoting men's awareness of testicular diseases. The Enhancing Men's Awareness of Testicular diseases (E-MAT) feasibility trial aims to test the effect of E-MAT VR (intervention; interactive experience using virtual reality [VR]) compared to information delivered Electronically E-MAT E (control; same information as E-MAT VR delivered as plain text and images) on testicular knowledge, and testicular self-examination among male athletes affiliated with a national sports organisation. The overall aim of this mixed method process evaluation will be to describe (i) the experiences of participants and key stakeholders (e.g., researchers); (ii) the perceived effectiveness of intervention components; (iii) acceptability of the feasibility trial and intervention procedures; (iv) the relationship between implementation, mechanisms, and context; and (v) the barriers and facilitators to support effective conduct of a future definitive trial. Methods: This mixed method process evaluation will use a descriptive realist evaluation. Quantitative data will be gathered using a usability and satisfaction survey, in addition to fidelity checks during intervention delivery. Quantitative data will be analysed using descriptive and inferential statistics. Qualitative data will be gathered from semi-structured interviews and focus groups with participants and key stakeholders to investigate their experiences of E-MAT VR and E-MAT E, and explore areas for improvement. Thematic analysis of transcripts will be conducted. Conclusions: This process evaluation will provide an in-depth understanding of how the interventions worked within this cohort and lessons for a future definitive trial.
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Affiliation(s)
- Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Megan McCarthy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Frances Shiely
- Trials Research and Methodologies Unit, Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Janas M. Harrington
- Health Research Board Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - Gillian Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - David Murphy
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Billy O'Mahony
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mohamad M. Saab
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Rovito MJ, Allen K, Nangia A, Craycraft M, Cary C, Lutz M, Lyon T, Fadich A, Baird B, Welch MG, Alcantara A. A Call to Action to Review the USPSTF's Recommendation for Testicular Self-Examination. Am J Mens Health 2022; 16:15579883221130186. [PMID: 36214273 PMCID: PMC9558879 DOI: 10.1177/15579883221130186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Michael J. Rovito
- Testicular Cancer Research
Collaborative, Department of Health Sciences, College of Health Professions and
Sciences, University of Central Florida, Orlando, FL, USA,Michael J. Rovito, Testicular Cancer
Research Collaborative, Department of Health Sciences, College of Health
Professions and Sciences, University of Central Florida, 4364 Scorpius St., HS2
Room 215, Orlando, FL 32828, USA.
| | - Keri Allen
- Testicular Cancer Research
Collaborative, Department of Health Sciences, College of Health Professions and
Sciences, University of Central Florida, Orlando, FL, USA
| | - Ajay Nangia
- Department of Urology, University of
Kansas Medical Center, Kansas City, KS, USA
| | | | - Clint Cary
- Indiana University, Indianapolis, IN,
USA
| | - Michael Lutz
- Michigan Institute of Urology, West
Bloomfield, MI, USA
| | | | - Ana Fadich
- Men’s Health Network, Washington, DC,
USA
| | | | - Morgan Garrett Welch
- Testicular Cancer Research
Collaborative, Department of Health Sciences, College of Health Professions and
Sciences, University of Central Florida, Orlando, FL, USA
| | - Alexie Alcantara
- Testicular Cancer Research
Collaborative, Department of Health Sciences, College of Health Professions and
Sciences, University of Central Florida, Orlando, FL, USA
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Rovito MJ, Craycraft M, Adams WB, Maresca M, Saab MM, Cary C, Gooljar C, Martinez S, Abu Zanet R. A Cross-Sectional Analysis of Testicular Cancer Symptom Recognition and Stage of Diagnosis. Am J Mens Health 2022; 16:15579883221104900. [PMID: 35723132 PMCID: PMC9344164 DOI: 10.1177/15579883221104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Michael J Rovito
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | | | - Wesley B Adams
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Michael Maresca
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Clint Cary
- Health Simon Cancer Center, Indiana University, Indianapolis, IN, USA
| | - Chayna Gooljar
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Sydney Martinez
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Rama Abu Zanet
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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Rovito MJ, Adams WB, Craycraft M, Gooljar C, Maresca M, Guelmes J, Gallelli A. The Association Between Testicular Self-Examination and Stages of Testicular Cancer Diagnosis: A Cross-Sectional Analysis. J Adolesc Young Adult Oncol 2021; 11:41-47. [PMID: 33877917 DOI: 10.1089/jayao.2021.0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Michael J Rovito
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Wesley B Adams
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | | | - Chayna Gooljar
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Michael Maresca
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Janet Guelmes
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Alexa Gallelli
- Department of Health Sciences, Testicular Cancer Research Collaborative, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
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Pietrzyk Ł, Denisow-Pietrzyk M, Czeczelewski M, Ślizień-Kuczapski K, Torres K. Cancer education matters: a report on testicular cancer knowledge, awareness, and self-examination practice among young Polish men. Sci Rep 2020; 10:20684. [PMID: 33244121 PMCID: PMC7693263 DOI: 10.1038/s41598-020-77734-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022] Open
Abstract
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.
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Affiliation(s)
- Łukasz Pietrzyk
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland. .,Department of General, Oncological, and Minimally Invasive Surgery, 1st Military Clinical Hospital With the Outpatient Clinic in Lublin, Lublin, Poland.
| | - Marta Denisow-Pietrzyk
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Marcin Czeczelewski
- Students' Scientific Association of Medical Simulation, Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Konrad Ślizień-Kuczapski
- Students' Scientific Association of Medical Simulation, Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Kamil Torres
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
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10
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Bresciani M, Boarin M, Facconi I, Manara DF, Villa G. Awareness of testicular cancer among young men: A literature review. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Martina Bresciani
- Department of Abdominal‐Pelvic Surgery European Institute of Oncology Milan Italy
| | - Mattia Boarin
- Department of Urology San Raffaele Institute Milan Italy
| | - Ilaria Facconi
- Department of Orthopaedics San Raffaele Institute Milan Italy
| | - Duilio F. Manara
- School of Nursing Center for Nursing Research and Innovation, Università Vita‐Salute San Raffaele Milan Italy
| | - Giulia Villa
- Department of Urology San Raffaele Institute Milan Italy
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11
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Rovito MJ, Taylor S, Lockwood R, Adams WB, Craycraft M. Testicular Cancer Incidence and Mortality Within Rural and Urban Regions. J Adolesc Young Adult Oncol 2019; 9:202-207. [PMID: 31742479 DOI: 10.1089/jayao.2019.0102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Testicular cancer (TCa) is among the most common cancers within adolescent and young adult (AYA) male populations. However, information is limited to variations in incidence and mortality outside of racial/ethnic subgroups. Rural regions historically have a greater overall cancer incidence than urban regions, although some key differences exist regarding site. TCa-specific incidence and mortality disparities are not commonly reported in this context. This study aims to help fill that gap by providing discovery evidence if there is an association between US rural/urban regions and TCa incidence and mortality. Methods: Secondary analysis of Surveillance, Epidemiology, and End Results incidence and mortality data were employed to determine if rural/urban TCa incidence and mortality disparities exist among U.S. males. Results: There was a 2.6% increased rate of TCa in U.S. urban as compared with rural geographic regions from 2011 to 2015. When geographic region is disaggregated, rural regions see higher rates than urban. When factoring in race/ethnicity, White/Caucasians and Hispanics had statistically higher urban rates whereas American Indian/Alaskan Natives and Asian/Pacific Islander groups had statistically higher rural rates. Conclusion: Geographic regional TCa variation research is virtually nonexistent for U.S. males, specifically AYAs of color. Determining preliminary trends in rural and urban regions can assist in the creation of more targeted services, particularly among underserved and vulnerable populations that have tenuous access to health care, to reduce disparate health outcomes. Exploring geographic differences in TCa incidence and mortality can have implications within service industry, health care accessibility, and public health justice areas of research and outreach.
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Affiliation(s)
- Michael J Rovito
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
| | - Skyler Taylor
- Southern Illinois University School of Medicine, Springfield, Illinois
| | - Ryan Lockwood
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
| | - Wesley B Adams
- Testicular Cancer Research Collaborative, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
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12
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Drevinskaite M, Patasius A, Kincius M, Jievaltas M, Smailyte G. A Population-Based Analysis of Incidence, Mortality, and Survival in Testicular Cancer Patients in Lithuania. ACTA ACUST UNITED AC 2019; 55:medicina55090552. [PMID: 31480363 PMCID: PMC6780107 DOI: 10.3390/medicina55090552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Background and objectives: The aim of this study was to analyze trends in testicular cancer incidence, mortality, and survival in Lithuania during the period 1998–2013. Materials and Methods: The study was based on all cases of testicular cancer reported to the Lithuanian Cancer Registry between 1998 and 2013. Age group-specific rates and standardized rates were calculated using the direct method (European standard population). The Joinpoint regression model was used to provide the annual percentage change (APC). Five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of cancer patients and the expected survival of the underlying general population. Results: During the study period, the age-standardized incidence rate of testicular cancer increased from 1.97 to 3.45 per 100,000, with APC of 2.97% (95% CI 0.9 to 5.1). Incidence rate of seminomas changed from 0.71 to 1.54 per 100,000, with APC of 2.61% (95% CI −0.4 to 5.7), and the incidence rate of non-seminomas increased from 0.84 to 1.83 per 100,000, with APC of 4.16% (95% CI 1.6 to 6.8). The mortality rate of testicular cancer in Lithuania during this period declined from 0.78 to 0.51 per 100,000, with APC of −2.91% (95% CI −5.5 to −0.3). Relative five-year survival ratio for the period 2009–2013 was 89.39% (95% CI 82.2 to 94.4). In our study, the overall five-year relative survival increased slightly (10.1%) from 2004–2008 to 2009–2013 (from 79.3% to 89.4%). Conclusions: A moderate increase of testicular cancer incidence has been observed in Lithuania between the years 1998 and 2013, while the mortality rate decreased. The five-year relative survival increased according to different period estimates; however, the results could have been higher if a multidisciplinary approach to diagnostics and management in the concerned centers had been implemented in Lithuania as in other countries.
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Affiliation(s)
- Mingaile Drevinskaite
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania.
| | - Ausvydas Patasius
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Marius Kincius
- Department of Oncourology, National Cancer Institute, 08406 Vilnius, Lithuania
| | - Mindaugas Jievaltas
- Urology department, Lithuanian University of Health Sciences, Medicine Academy, 44307 Kaunas, Lithuania
| | - Giedre Smailyte
- Laboratory of Cancer Epidemiology, National Cancer Institute, 08406 Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
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