Testicular Cancer: Screening -- Adolescent and Adult Men


General

Grade: D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Discourage the use of this service.

Specific Recommendations

The USPSTF recommends against screening for testicular cancer in adolescent or adult males.

Frequency of Service

No information available.

Risk Factor Information

No information available.


Clinical

Clinical Considerations

Patient Population Under Consideration

This recommendation applies to asymptomatic adolescent or adult males. The USPSTF did not review the evidence for screening males with a history of cryptorchidism.

Screening Tests

The sensitivity, specificity, and positive predictive value of testicular examination in asymptomatic patients are unknown. Screening examinations performed by patients or clinicians are unlikely to provide meaningful health benefits because of the low incidence and high survival rate of testicular cancer, even when it is detected at symptomatic stages.

Treatment

Management of testicular cancer consists of orchiectomy and may include other surgery, radiation therapy, and chemotherapy, depending on the disease stage and tumor type. Regardless of disease stage, more than 90% of all newly diagnosed cases of testicular cancer will be cured.

Useful Resources

The National Cancer Institute's Physician Data Query, available at www.cancer.gov/cancertopics/pdq, is a comprehensive database that contains summaries on a wide range of cancer-related topics for health professionals and patients, including testicular cancer screening and treatment.


Rationale

Importance

Testicular cancer (a primary germ-cell tumor of the testis) is the most common cancer among males aged 15 to 34 years. However, with an annual incidence rate of 5.4 cases per 100,000 males, testicular cancer is relatively rare compared with other types of cancer.

Detection

Most cases of testicular cancer are discovered accidentally by patients or their partners. There is inadequate evidence that screening by clinician examination or patient self-examination has a higher yield or greater accuracy for detecting testicular cancer at earlier (and more curable) stages.

Benefits of Detection and Early Intervention

Based on the low incidence of this condition and favorable outcomes of treatment, even in cases of advanced disease, there is adequate evidence that the benefits of screening for testicular cancer are small to none.

Harms of Detection and Early Intervention

Potential harms associated with screening for testicular cancer include false-positive results, anxiety, and harms from diagnostic tests or procedures. The USPSTF found no new evidence on potential harms of screening and concluded that these harms are no greater than small.

USPSTF Assessment

The USPSTF concludes that there is moderate certainty that screening for testicular cancer has no net benefit.


Others

Recommendations of Others The American Academy of Family Physicians recommends against routine screening for testicular cancer in asymptomatic adolescent and adult males. The American Academy of Pediatrics does not include screening for testicular cancer in its recommendations for preventive health care. Finally, the American Cancer Society does not recommend testicular self-examination.


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