Skip to content

Cancer Health Center

Font Size

Testicular Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - Description of the Evidence

continued...

Most testicular cancers are first detected by the patient, either unintentionally or by self-examination. Some are discovered by routine physical examination. However, no studies have been done to determine the effectiveness of testicular self-examination or clinical testicular examination in reducing mortality from testicular cancer. An updated systematic review performed on behalf of the U.S. Preventive Services Task Force, published in 2010, found no randomized trials, cohort studies, or case-control studies that examined benefits of testicular cancer screening (whether by physical examination, self-examination, or other screening tests) in an asymptomatic population.[21] Likewise, a systematic Cochrane Collaboration review found no randomized or quasi-randomized controlled trials that evaluated the effectiveness of screening by a health professional or patient self-examination.[23]

Screening would be very unlikely to decrease mortality substantially because therapy is so effective at virtually all stages of disease.[24](Refer to the PDQ summary on Testicular Cancer Treatment for more information.) However, early detection may affect therapy. There is an increase in both the number of courses of chemotherapy and the extent of surgery required for treatment of advanced disease that results in higher morbidity. Patients diagnosed with localized disease require less treatment and have lower morbidity.[25]

Evidence of Harm Associated With Screening

Harms of screening for testicular cancer are poorly quantified. They may include false positive tests [22] and resulting anxiety as well as subsequent unwarranted invasive diagnostic procedures. Two systematic reviews found no studies that provided a quantitative assessment of the harms of screening. [21,23]

References:

  1. American Cancer Society.: Cancer Facts and Figures 2013. Atlanta, Ga: American Cancer Society, 2013. Available online. Last accessed March 13, 2013.
  2. McGlynn KA, Devesa SS, Sigurdson AJ, et al.: Trends in the incidence of testicular germ cell tumors in the United States. Cancer 97 (1): 63-70, 2003.
  3. Garner MJ, Turner MC, Ghadirian P, et al.: Epidemiology of testicular cancer: an overview. Int J Cancer 116 (3): 331-9, 2005.
  4. Huyghe E, Matsuda T, Thonneau P: Increasing incidence of testicular cancer worldwide: a review. J Urol 170 (1): 5-11, 2003.
  5. Horwich A, Shipley J, Huddart R: Testicular germ-cell cancer. Lancet 367 (9512): 754-65, 2006.
  6. Howlader N, Noone AM, Krapcho M, et al., eds.: SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). Bethesda, Md: National Cancer Institute, 2012. Also available online. Last accessed February 21, 2013.
  7. Dieckmann KP, Pichlmeier U: Clinical epidemiology of testicular germ cell tumors. World J Urol 22 (1): 2-14, 2004.
  8. Richie JP, Steele GS: Neoplasms of the testis. In: Campbell MF, Wein AJ, Kavoussi LR: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier, 2007, pp 893-935.
  9. Moul JW, Schanne FJ, Thompson IM, et al.: Testicular cancer in blacks. A multicenter experience. Cancer 73 (2): 388-93, 1994.
  10. Henderson BE, Benton B, Jing J, et al.: Risk factors for cancer of the testis in young men. Int J Cancer 23 (5): 598-602, 1979.
  11. Dieckmann KP, Pichlmeier U: The prevalence of familial testicular cancer: an analysis of two patient populations and a review of the literature. Cancer 80 (10): 1954-60, 1997.
  12. Jacobsen R, Bostofte E, Engholm G, et al.: Risk of testicular cancer in men with abnormal semen characteristics: cohort study. BMJ 321 (7264): 789-92, 2000.
  13. Walsh TJ, Croughan MS, Schembri M, et al.: Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med 169 (4): 351-6, 2009.
  14. Hotaling JM, Walsh TJ: Male infertility: a risk factor for testicular cancer. Nat Rev Urol 6 (10): 550-6, 2009.
  15. Fosså SD, Chen J, Schonfeld SJ, et al.: Risk of contralateral testicular cancer: a population-based study of 29,515 U.S. men. J Natl Cancer Inst 97 (14): 1056-66, 2005.
  16. Richiardi L, Pettersson A, Akre O: Genetic and environmental risk factors for testicular cancer. Int J Androl 30 (4): 230-40; discussion 240-1, 2007.
  17. Olesen IA, Hoei-Hansen CE, Skakkebaek NE, et al.: Testicular carcinoma in situ in subfertile Danish men. Int J Androl 30 (4): 406-11; discussion 412, 2007.
  18. Jørgensen N, Müller J, Giwercman A, et al.: Clinical and biological significance of carcinoma in situ of the testis. Cancer Surv 9 (2): 287-302, 1990.
  19. Dieckmann KP, Loy V: Prevalence of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms. J Clin Oncol 14 (12): 3126-32, 1996.
  20. U.S. Preventive Services Task Force.: Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 154 (7): 483-6, 2011.
  21. Lin K, Sharangpani R: Screening for testicular cancer: an evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 153 (6): 396-9, 2010.
  22. Carmignani L, Gadda F, Gazzano G, et al.: High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol 170 (5): 1783-6, 2003.
  23. Ilic D, Misso ML: Screening for testicular cancer. Cochrane Database Syst Rev (2): CD007853, 2011.
  24. Feldman DR, Bosl GJ, Sheinfeld J, et al.: Medical treatment of advanced testicular cancer. JAMA 299 (6): 672-84, 2008.
  25. Sagalowsky AI: Expectant management of stage A nonseminomatous testicular tumors. In: Ratiff TL, Catalona WJ, eds.: Genitourinary Cancer. Boston: Martinus Nijhoff, 1987, pp 225-237.
1|2|3
1|2|3

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

Colorectal cancer cells
A common one in both men and women.
Lung cancer xray
See it in pictures, plus read the facts.
 
sauteed cherry tomatoes
Fight cancer one plate at a time.
Ovarian cancer illustration
Do you know the symptoms?
 
Jennifer Goodman Linn self-portrait
Blog
what is your cancer risk
HEALTH CHECK
 
colorectal cancer treatment advances
Video
breast cancer overview slideshow
SLIDESHOW
 
prostate cancer overview
SLIDESHOW
lung cancer overview slideshow
SLIDESHOW
 
ovarian cancer overview slideshow
SLIDESHOW
Actor Michael Douglas
Article