Testicular Cancer Awareness and Knowledge: Is It the Same? Exploratory Study in a Mixed-Gender Population

Knowledge on the male reproductive tract and testicular cancer among adolescents in Austria

PURPOSE

Testicular cancer is the most frequent malignant tumour among young adults. Therefore, regular self-examination for early detection is recommended by all guidelines. The fact that the knowledge of young adults living in Austria on this important topic is unknown, prompted the current investigation.

MATERIALS AND METHODS

To evaluate the knowledge on anatomy and function of the male reproductive tract and of testicular cancer in particular a German questionnaire recently developed by Anheuser et al. (Urologe 2019;58:1331-1337) was applied. This 4-page questionnaire contains mainly multiple-choice questions. This questionnaire was distributed in three different schools to male and female students in the 11th and 12th school level.

RESULTS

A total of 337 students (mean age: 17.3 years; male: n = 183; female: n = 154) completed the questionnaire. In a simple pictogramm, 63% were able to correctly identify the prostate, 87% the testis and 64% the epididymis. Half of the students (49.3%) could describe the function of the testis. The question regarding the age peak of testicular cancer was correctly answered by 81%, yet 18% believed that testicular cancer is caused by the sexual contact. The purpose of the testicular self-examination was correctly answered by only 54.9% with a higher rate for women (67.5% vs. 44.3%, p = 0.001). With a theoretical maximal score of 15, the students reached a mean overall of 10.4 with no sex difference (p > 0.05). Differences were noted for the school type: the highest score was present in the Gymnasium (11.2), followed by the Realgymnasium (10.8) and the HTL (9.8; p = 0.001).

CONCLUSIONS

This survey demonstrates relevant knowledge deficits of young adults regarding the male reproductive tract, testicular cancer and self-examination.

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.

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.

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.

Evaluation of Testicular Self Examination and Testicular Partner Examination in Medical versus Non-Medical Students

Objectives

Although testicular cancer (TC) is the most common tumor in young men in Western countries, there is no official cancer detection/screening program for young men in Germany. The most important TC detection tool is self-examination of the testis. Hypothetically medical students may have a diagnosis lead time and detection superiority. This study was designed to analyze whether medical students have a possible knowledge advantage over students of other faculties concerning TC and to compare male and female cancer screening demeanor and mentality.

Methods

Male and female students of various faculties at the Goethe University Frankfurt/Main, Germany were invited to participate in this internet-based anonymous questionnaire with questions about TC awareness/knowledge, testicular (self) examination, and cancer screening behavior.

Results

In total 1,049 students (329 medical and 716 non-medical students) completed the questionnaire. In general, medical students had a significantly higher TC knowledge, especially in the more advanced stages of their medical studies (year 3-6). About 50% of medical students had knowledge of TC whereas only 21.3% of non-medical students knew about the disease (p < 0.01). In addition, medical students conducted scrotal examinations more frequently (34.7%) than non-medical students (18.8%).

Conclusion

The knowledge about TC is low among students. In general, medical students are more aware of TC and perform more frequent testicular examinations compared to non-medical students. Female TC knowledge rises in the clinical part of studies to the same level as their male counterparts, with the result of more testicular partner examinations.

Enhancing Men's Awareness of Testicular Disorders Using a Virtual Reality Intervention: A Pre-Post Pilot Study

BACKGROUND

The incidence of benign and malignant testicular disorders is on the rise. Three literature reviews and one qualitative study found that men's awareness of testicular disorders was lacking, and their intentions to seek help for symptoms of testicular disease were low.

OBJECTIVES

The aim of the study was to enhance men's awareness of testicular disorders, help-seeking intentions for testicular symptoms, and intention and behavior to feel their testes.

METHODS

Men aged 18-50 years were recruited from a university and asked to engage in a three-level, educational, virtual reality experience. The Medical Research Council framework guided the development and pilot testing of the intervention. Knowledge, awareness, perceived risk, implementation intentions, help-seeking intentions, and behaviors were measured at pretest (T0), immediately posttest (T1), and 1 month posttest (T2).

RESULTS

Data were available from 49 participants. In comparison to T0, a significant increase in knowledge (mean difference [MD] = 3.5, 95% CI [2.8, 4.26]); testicular awareness (MD = 0.2, 95% CI [0.01, 0.41]); implementation intentions (MD = 0.6, 95% CI [0.33, 0.90]); and help-seeking intentions for testicular swelling (MD = 0.3, 95% CI [0.12, 0.51]), lumpiness (MD = 0.3, 95% CI [0.08, 0.46]), and pain (MD = 0.6, 95% CI [0.25, 1.01]) was noted at T1. This increase was maintained at T2. Participants who expressed an intention to feel their testes at T0 were more likely to report performing this behavior at T2.

DISCUSSION

The intervention succeeded in promoting knowledge, testicular awareness, implementation intentions, help-seeking intentions, and behaviors. A randomized controlled trial of the Enhancing Men's Awareness of Testicular Disorders intervention with a larger sample size is warranted.

Has increasing public health awareness influenced the size of testicular tumours among adult populations over the last 40 years?

Background

Testicular cancer is the commonest malignancy in young men. Improvements in survival rates have led to campaigns to raise awareness in at-risk men. We assessed the changing size of testicular tumours given the public health initiatives promoting testicular self-examination (TSE).

Methods

Retrospective analysis of men (≥16 years) undergoing orchidectomy for testicular cancer at our institution over two time periods (1975-85 and 2007-12) were identified using our cancer registry. Histopathology reports were used to record testicular tumour size as the maximum measured dimension. Significance was indicated by P < 0.05.

Results

Of 305 orchidectomies performed, 215 had histopathology reports available. Median age was 34 years (16-75 years). Mean tumour size was 7.2 cm in 1975-85 and 4.1 cm in 2007-12 showing a significant reduction (P = 0.02). Significant reduction was seen in all age groups except >60 years. Furthermore there was a significant increase in proportion of men presenting in the youngest age group (16-29 years) in the 2007-12 cohort (43 versus 29%, P = 0.02).

Conclusion

The trend in reduction of tumour size at presentation and increased proportion of younger men presenting with testicular cancer supports an increased awareness. Promotion of TSE and public education should remain important initiatives given the increasing incidence of testicular cancer. Awareness still needs addressing in older men.

Affluence and Private Health Insurance Influence Treatment and Survival in Non-Hodgkin's Lymphoma

BACKGROUND

The aim of this study was to investigate inequalities in survival for non-Hodgkin's lymphoma (NHL), distinguishing between direct and indirect effects of patient, social and process-of-care factors.

METHODS

All cases of NHL diagnosed in Ireland in 2004-2008 were included. Variables describing patient, cancer, stage and process of care were included in a discrete-time model of survival using Structural Equation Modelling software.

RESULTS

Emergency admissions were more common in patients with co-morbid conditions or with more aggressive cancers, and less frequent for patients from more affluent areas. Aggressive morphology, female sex, emergency admission, increasing age, comorbidity, treatment in a high caseload hospital and late stage were associated with increased hazard of mortality. Private patients had a reduced hazard of mortality, mediated by systemic therapy, admission to high caseload hospitals and fewer emergency admissions.

DISCUSSION

The higher rate of emergency presentation, and consequent poorer survival, of uninsured patients, suggests they face barriers to early presentation. Social, educational and cultural factors may also discourage disadvantaged patients from consulting with early symptoms of NHL. Non-insured patients, who present later and have more emergency admissions would benefit from better access to diagnostic services. Older patients remain disadvantaged by sub-optimal treatment, treatment in non-specialist centres and emergency admission.