Factors associated with testicular self-examination among unaffected men from multiple-case testicular cancer families

Susan T Vadaparampil,June A Peters,Mark H Greene,Richard P Moser,Jennifer Loud,Larissa Korde

doi:10.1186/1897-4287-7-11

Abstract

BackgroundThe lifetime testicular cancer (TC) risk in the general population is relatively low (~1 in 250), but men with a family history of TC are at 4 to 9 times greater risk than those without. Some health and professional organizations recommend consideration of testicular self-examination (TSE) for certain high-risk groups (e.g. men with a family history of TC). Yet little is known about factors associated with TSE behaviors in this at-risk group.MethodsWe collected information on this subject during an on-going NCI multidisciplinary, etiologically-focused, cross-sectional Familial Testicular Cancer (FTC) study. We present the first report specifically targeting TSE behaviors among first- and second-degree relatives (n = 99) of affected men from families with ≥ 2 TC cases. Demographic, medical, knowledge, health belief, and psychological factors consistent with the Health Belief Model (HBM) were evaluated as variables related to TSE behavior, using chi-square tests of association for categorical variables, and t-tests for continuous variables.ResultsFor men in our sample, 46% (n = 46) reported performing TSE regularly and 51% (n = 50) reported not regularly performing TSE. Factors associated (p < .05) with regularly performing TSE in multivariate analysis were physician recommendation and testicular cancer worry. This is the first study to examine TSE in unaffected men from FTC families.ConclusionThe findings suggest that, even in this high-risk setting, TSE practices are sub-optimal. Our data provide a basis for further exploring psychosocial issues that are specific to men with a family history of TC, and formulating intervention strategies aimed at improving adherence to TSE guidelines.

Highlights

Testicular cancer (TC) accounts for only 1% of all male cancers, it is the most common cancer in younger men aged 20–35 years old, with about 8,090 new cases estimated to occur during 2008 in the U.S [1]
We present an analysis of data collected from participants in a National Cancer Institute (NCI) multidisciplinary, etiologically-focused study of familial testicular cancer (FTC)
Health Belief Model Variables We evaluated critical HBM concepts: perceived TC susceptibility and severity, as well as perceived benefits and barriers to testicular selfexamination (TSE)

Summary

Introduction

Testicular cancer (TC) accounts for only 1% of all male cancers, it is the most common cancer in younger men aged 20–35 years old, with about 8,090 new cases estimated to occur during 2008 in the U.S [1]. Leading health organizations debate the efficacy of testicular self-examination (TSE) in reducing TC related mortality [8], with the advent of chemotherapeutic regimens that are highly-effective even for men with advanced disease during the last several decades. This decrease in mortality is accompanied by an increase in treatment-related morbidity, for those cancers that are diagnosed at later stages [6,9]. While TSE may not markedly improve the already high survival rates related to TC, early diagnosis does bring significant potential to reduce treatment-related morbidity, since surgery plus close surveillance is a viable management option for many early-stage patients [10]. Little is known about factors associated with TSE behaviors in this at-risk group

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Results

Conclusion