414 NATIONAL INCIDENCE OF TESTICULAR EXAMINATION IN MEN AGES 15-45 PREDICTIVE FACTORS AND BARRIERS

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness III1 Apr 2012414 NATIONAL INCIDENCE OF TESTICULAR EXAMINATION IN MEN AGES 15-45 PREDICTIVE FACTORS AND BARRIERS Kunj R. Sheth, Vidit Sharma, Sherwin Zargaroff, Brian Le, James M. Dupree, and Robert Brannigan Kunj R. ShethKunj R. Sheth Chicago, IL More articles by this author , Vidit SharmaVidit Sharma Chicago, IL More articles by this author , Sherwin ZargaroffSherwin Zargaroff Chicago, IL More articles by this author , Brian LeBrian Le Chicago, IL More articles by this author , James M. DupreeJames M. Dupree Chicago, IL More articles by this author , and Robert BranniganRobert Brannigan Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.480AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular cancer is the most common malignancy in men aged 20-40 years and the second most common cancer in men aged 15-19 years. Approximately 10-30% of cases present with metastatic disease, raising concerns about delays in diagnosis in these men. The American Cancer Society states that 'most doctors agree that examining a man's testicles should be part of a general physical exam,' and this approach might facilitate early detection of testicular cancer in affected men. Here we use a nationwide survey to assess frequency of both general physical exam, and more specifically, testicular exam, in the 12 months prior to the survey. METHODS From 2006-2010, the CDC conducted the National Survey for Family Growth sampling 10,403 men aged 15-45. The probabilistic and clustered design of the survey yields national extrapolations that we have previously validated using an internal control. We used descriptive statistics and multivariate regression models to isolate characteristics of those men receiving testicular exams. RESULTS From 2006-2010 an estimated 36.9% (22,923,994) of men aged 15-45 had a testicular examination within the last 12 months. Multivariate regression shows testicular exams were significantly (p<0.05) less common in immigrants (OR:0.72), older men (OR: 0.98), men lacking a consistent health care provider (OR: 0.74), and Caucasians compared to African Americans (OR: 0.78). As expected, the most significant factor leading to a testicular exam in the past 12 months was having a physical exam (OR: 43.0, 95%CI: 36.6-49.2]. However, of the 29,314,526 men who had a routine physical, 27.8% (8,128,713) did not have a testicular exam. A second regression model of men who received a routine physical exam showed that older age (OR: 0.97) and ethnicity (Caucasian versus African American, OR: 0.77) remained significant (p<0.05) barriers to receiving a testicular exam. Furthermore, patients using a community or public health clinic were less likely to have a testicular exam during their routine physical compared to those using a private doctor's office(OR: 0.66, 95% CI: 0.53-0.81). CONCLUSIONS In this study, the annual incidence of testicular exam in men 15-45 years of age is only 36.9%. Surprisingly, 27.8% of men who had a routine physical did not have a testicle exam. This is concerning, as males in this age group are at the highest risk for testicular cancer. To facilitate early detection of testicular cancer and potentially help decrease the morbidity of higher stage disease, providers should consider conducting testicular exams as part of a complete physical exam. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e169-e170 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kunj R. Sheth Chicago, IL More articles by this author Vidit Sharma Chicago, IL More articles by this author Sherwin Zargaroff Chicago, IL More articles by this author Brian Le Chicago, IL More articles by this author James M. Dupree Chicago, IL More articles by this author Robert Brannigan Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...