Screening for testicular cancer

Testicular cancer commonly affects men aged between 20 and 35 years. It accounts up to 2% of cancers diagnosed in men, although the lifetime risk of mortality is less than 1%. Screening for testicular cancer is commonly performed by physician, who performs a physical examination, or self-examination by the patient. However, there is little evidence that documents the accuracy of such examinations. This review identified that no randomised controlled trials have been performed to evaluate the effectiveness of screening for testicular cancer. In the absence of high quality evidence, male patients with an increased risk of developing testicular cancer should be informed of the potential benefits and harms associated with screening.

Authors' conclusions: 

Patients with increased clinical risk factors for testicular cancer, including a family history of testicular cancer, undescended testis (cryptorchidism) or testicular atrophy should be informed by their physicians of their potential increased risk of testicular cancer, along with potential benefits and harms associated with screening.

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Background: 

Testicular cancer commonly affects men aged between 20 and 35 years. Screening for testicular cancer may reduce both morbidity and mortality, yet the effectiveness of any method is unknown. Equally, screening may also promote treatment procedures that are unwarranted or may adversely affect the health outcomes of the patient with no net benefit. Additionally, many organisations recommend against screening for testicular cancer due to the low incidence of testicular cancer and favourable outcomes in the absence of screening.

Objectives: 

The primary objective of this review is to determine whether screening for testicular cancer (physician or patient self-examination) reduces testicular cancer-specific mortality. The secondary objective of this review is to determine impact of screening for testicular cancer on quality of life and adverse outcomes.

Search strategy: 

Electronic searches were conducted across MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL) and PsychINFO through 9 June 2010.

Selection criteria: 

All published randomised controlled trials (RCTs) of screening versus no screening for testicular cancer were eligible for inclusion in this review.

Data collection and analysis: 

The search identified 19 potentially relevant articles, which were selected for full text review. None of the articles that were reviewed were evaluated as eligible for inclusion in this review.

Main results: 

There are no published RCTs evaluating the effectiveness of screening for testicular cancer.

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