Abstract
Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men's knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men's awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.
Highlights
According to the National Cancer Institute, testicular cancer (TC) is most commonly diagnosed among men aged 15 to 40 years
This study found that only 39% of participants correctly identified the TC at-risk age group, and only 17% were aware of TSE11
Examples of interventions that successfully increased men’s awareness of TC and testicular self-examination (TSE) included: a university campaign that involved the use of TC “flyers, brochures, posters, shower cards, bulletin boards, social networking sites, videos, newspaper advertisements, a website, and mass media” (p.305)[31]; a television show featuring a celebrity with TC32; and TC and TSE factsheets and testimonies from fictitious patients[33]
Summary
According to the National Cancer Institute, testicular cancer (TC) is most commonly diagnosed among men aged 15 to 40 years. The incidence of TC has doubled globally over the past 40 years and is highest in Western and Northern European countries, Australia, and North America[1,2]. According to the National Cancer Registry Ireland, 90% of TC cases and 85% of TC deaths in Ireland occur among men younger than 50 years. A unilateral painless testicular mass is a classical sign of TC. Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. Results: There were five papers included: two were experimental version 2 (revision)
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