Do men want to perform testicular self-examination?

Abstract

395 Background: Early detection of testicular cancer (TC) may reduce the required burden of therapy. The long-term adverse effects of therapy in TC survivors are becoming increasingly recognized. The U.S. Preventive Services Task Force (USPSTF) currently recommends against testicular self-examinations (TSE) for TC screening due to a low incidence and lack of data to support a benefit. Our objective was to better understand the baseline knowledge and practices of men in the general population regarding TC/TSE in an effort to understand whether current screening guidelines reflect their viewpoint. Methods: This was a prospective survey study (51 questions). Participants (N=250; MAge=33 years, IQR: 28-39) were recruited via Amazon Mechanical Turk, a crowdsourcing platform used recruit minimally compensated participants. This platform has been extensively validated in US populations as being concordant with surveys conducted by other methods. Results: Most respondents were white (65.6%), had a college degree (76.4%), and did not work in a medical field (89.6%). Men rated themselves as “somewhat unknowledgeable” about testicular cancer, with no respondents considering themselves “very knowledgeable”. Only 26.4% of men knew that testicular cancer was curable most of the time. Despite 90.8% of men feeling that their doctor had at least some role in discussing TC/TSE, only 17.2% had actually discussed these topics with their doctor. Even after being informed of the rationale behind USPSTF recommendations, only 8% of men thought that potential false positives of TSE would be more important than the rare chance of finding early testicular cancer. Conclusions: Based on the largest survey of American men regarding testicular self-examination since the 2009 USPSTF recommendations, men don’t feel knowledgeable about testicular cancer, have a favorable attitude towards testicular self-examination, and want their doctor to discuss these topics. Shared decision making regarding testicular cancer screening is warranted given the low risk of harm and patient interest.