Early Detection Of Testicular Cancer Research Articles

Knowledge, Attitude and Practice of Testicular Self-Examination Among Male Undergraduate Students of Computing and Engineering Sciences in Babcock University, Ilishan-Remo, Ogun State

Testicular cancer is the most common cancer among young men and early detection improves its prognosis. Meanwhile, testicular self-examination (TSE) is a secondary prevention measure that is easy to perform and helps in the early detection of testicular cancer. There are limited studies to report the level of knowledge and practice of testicular self-examination. Therefore, this study is aimed to assess the knowledge, attitude and practice of testicular self-examination among male undergraduate students of Computing and Engineering Sciences in Babcock University, Ilishan Remo, Ogun State. A descriptive cross-sectional research with a sample of 290 undergraduate students was used for the study. The students offering a course in Computer school were purposively selected from the School of Computing and Engineering Sciences, a multistage sampling technique was used and they were stratified based on their educational levels. A simple random sampling technique was used to select the respondents. A self-structured online questionnaire was used for data collection. Ethical clearance to conduct the study was obtained from Babcock University Ethical Review Committee. Permission to conduct the study was sought from the School of Computing and Engineering Sciences in Babcock University and an informed consent form was attached to the questionnaire. Data were analysed using descriptive statistics. Results show that most of the participants (88.3%) were within the ages of 15-20. The majority (54.1%) had good knowledge of TSE, 41.0% had a positive attitude, but only 14.8% had ever practiced TSE and only 11.4 % had ever had their testicles examined by medical personnel. Despite good knowledge of TSE in this study, the findings revealed that knowledge is not commensurate to attitude and practice. This underscores the need to increase the awareness of TC and TSE among young men. Clinical testicular examination and education needs to be incorporated into routine examinations of young males.

Mevsimlik Tarım İşçisi Erkeklerin Testis Kanserine Yönelik Sağlık İnançlarının ve Testis Kanseri Erken Tanı Davranışlarının İncelenmesi

Background: One of the most effective methods of early detection of testicular cancer is applying testicular self examination. This study was conducted to determine the testicular cancer health beliefs and testicular cancer early diagnosis behaviors of young adult male seasonal agricultural workers. Materials and Methods: The study was of descriptive type and its sample consisted of 300 individu-als. Data were collected using Champion's Health Belief Model Scale in Testicular Cancer Screening and descriptive information form. In the analysis of the data, t-test and chi-square test were per-formed in independent groups. Results: It was determined that 6.3% of the individuals did at least one testicular self-examination during their lifetime and the total mean score of the health belief model scale was 15.39 ± 4.62. Conclusions: It is seen that the rate of individuals doing testicular self-examination and their health beliefs are not at the preferred level. For this reason, awareness studies should be carried out on testicular cancer and its early diagnosis. Key Words: Testicular cancer, Testicular self-examination, Seasonal agricultural worker

Testicular self-examination for early detection of testicular cancer.

Testicular cancer (TCa) commonly presents as a painless scrotal mass. It has been suggested that testicular self-examination (TSE) can help in early detection and thus potentially improve treatment outcomes and prognosis. While TSE is more well established in guideline recommendations for patients with a known history of TCa, its role in healthy young men is less established and controversial. In this paper, we review contemporary data to provide an updated recommendation.

Testicular Cancer Knowledge and Viewpoints of American Men.

We sought to better understand the baseline knowledge and practices of the general population regarding testicular cancer (TC) and testicular self-examination (TSE) in an effort to understand whether current screening guidelines reflect their viewpoint. The U.S. Preventive Services Task Force (USPSTF) currently recommends against TSE for TC screening due to a lack of data to support a benefit. Early detection of TC may reduce the required burden of therapy and associated long-term toxicities. This was a cross-sectional survey study. Participants (median age 33 years, IQR 28-39) were recruited via Amazon Mechanical Turk, a validated crowdsourcing platform used to recruit minimally compensated participants. A total of 250 men rated themselves as "somewhat unknowledgeable" about TC, with no respondents considering themselves "very knowledgeable." Only 26.4% of men knew that TC was curable most of the time. Despite 90.8% of men feeling that their doctor had some role in discussing TC/TSE, only 17.2% had 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 TC. American men do not feel knowledgeable about TC, have a favorable attitude toward TSE and want their doctor to discuss these topics. Shared decision making regarding TC screening is warranted given the low risk of harm and patient interest, and continued accrual of data on this topic is necessary given the lack of prospective work to date.

Knowledge, Attitude, and Practice regarding Testicular Cancer and Testicular Self-Examination among Male Students Pursuing Bachelor's Degree in Bharatpur Metropolitan City, Chitwan, Nepal.

Background Testicular cancer is a malignant tumor of the testicles, the male reproductive organs that produce sperm and testosterone. It is one of the most common cancers in young men. This form of cancer can be easily diagnosed by self-examination of testicles and is curable if detected early. Periodic self-examination must be performed for early detection. Due to lack of knowledge on testicular cancer and testicular self-examination techniques, patients can potentially miss early detection. This study is aimed at assessing the knowledge, attitude, and practice regarding testicular cancer and testicular self-examination among male college students pursuing a Bachelor's degree. Methods A web-based cross-sectional analytical study was adopted to assess the knowledge, attitude, and practice of testicular cancer and testicular self-examination among male college students pursuing a Bachelor's degree and living in Bharatpur Metropolitan City in the Chitwan District of Nepal. The snowball sampling technique was employed to identify the eligible participants. Collected data were entered in SPSS version 22 and analyzed by using the Chi-square test, Pearson's correlation, and binary logistic regression. Results Out of 402 respondents, majority (56.7%) had poor knowledge regarding testicular cancer and testicular self-examination and only 11.4% had performed testicular self-examination. The majority (67.2%) of the respondents had shown an unfavorable attitude towards testicular cancer (TC) and testicular self-examination (TSE). There was a significant association between the level of knowledge and marital status 4.516 (1.962-10.397) and ethnicity 2.606 (1.443-4.709). Likewise, age 0.396 (0.191-0.821) and marital status 0.347 (0.156-0.775) have been significantly associated with testicular self-examination practice. Regarding favorable attitude, age 0.362 (0.186-0.706) and sources of information from mass media 2.346 (1.328-4.143) have been associated significantly. Conclusion The study finding shows that the knowledge on testicular cancer and testicular self-examination was low. Due to lack of knowledge and trainings, the potential opportunities for early detection of testicular cancer are missed substantially. Periodic testicular self-examination is vital for early detection of testicular cancer. Hence, it is crucial to implement massive educational campaigns and trainings on testicular cancer and testicular self-examination techniques among young male groups.

Testicular and breast self-examination-a retrospective cohort study of medical students

HintergrundDurch eine regelmäßige Selbstuntersuchung kann ein Malignom der Hoden oder Brust gegebenenfalls frühzeitig erkannt und kurativ behandelt werden. Ziel dieser Arbeit war es, das Selbstuntersuchungsverhalten von Medizinstudierenden zu untersuchen und Faktoren, die eine regelmäßige Selbstuntersuchung beeinflussen, zu identifizieren.MethodikMedizinstudierende wurden mittels Fragebogen bezüglich ihres Gesundheits- und Sexualverhaltens befragt. 98,8 % der Studierenden nahmen teil (n = 473). Die erhobenen Daten wurden mittels univariater und multivariater logistischer Regression analysiert.ErgebnisseEs gaben 64,2 % der männlichen Studierenden (n = 177) an, regelmäßig ihre Hoden zu untersuchen und 72,2 % der weiblichen Studierenden (n = 296) gaben an, regelmäßig ihre Brust abzutasten. Studierende, die nicht mit ihrer/ihrem PartnerIn bzw. mit ihren FreundInnen über ihre Sexualität sprechen, führten seltener eine Selbstuntersuchung durch (p < 0,05). Männliche Studierende, die in den letzten 4 Wochen vor Befragung keinen Geschlechtsverkehr hatten und weibliche Studierende, die im gleichen Zeitraum nicht masturbierten, führten seltener eine Selbstuntersuchung durch (p < 0,05).DiskussionDer Anteil an Medizinstudierenden, der eine regelmäßige Selbstuntersuchung durchführt, ist im Vergleich zu weniger medizinisch gebildeten jungen Erwachsenen hoch. Wissen über die Relevanz von Hoden- bzw. Brustkrebs scheint grundlegend für eine regelmäßige Selbstuntersuchung zu sein. Ein belastetes Sexualleben schränkt solch ein Gesundheitsverhalten möglicherweise ein. Eine Verbesserung der Aufklärung über Hodenkrebs und die urologische Anbindung von Jungen/junger Männer bieten daher die Möglichkeit, die Bereitschaft zur Selbstuntersuchung innerhalb dieser Altersgruppe zu steigern.

The Evaluation of Training Program for Nursing Students on Testicular Cancer and Testicular Self-Examination

Background: Testicular self-examination (TSE) is one of the most effective ways for the early detection of testicular cancer. The Medical Association and American Urological Association recommend raising the awareness of TSE and educating the public in this regard for early diagnosis. Objectives: The present study aimed to evaluate the effect of the training given to nursing students for testicular cancer and TSE on the knowledge levels of the students. Methods: The current single-group pretest-posttest quasi-experimental study was carried out on the students continuing their education and training in the Faculty of Health Sciences of a university in Turkey within 2018 and 2019 (n=83). No sample selection was made for the determination of the study subjects (n=56). The research data were collected using a questionnaire. The data were evaluated by appropriate statistical methods, and a p-value of less than 0.05 was considered statistically significant. Results: The students participating in the study were within the age range of 20-26 years. In addition, 51.8% of the study subjects were male. Moreover, 58.9% of the students in the study stated that they did not receive any training for testicular cancer and TSE. Furthermore, 80.4% of the male students did not perform TSE 43.6% of whom reported that they did not know how to do it. However, the mean test scores of the participants for testicular cancer and TSE were reported as 12.84 and 15.73 prior to and after the training, respectively, . Nevertheless, the rate of TSE among the students was previously reported as 19.6% and increased to 100% after the training. Conclusions: In this study, it was concluded that the participants, even with an ordinary awareness-raising campaign, could be informed about testicular cancer and TSE. It is recommended to raise the awareness of society in this regard through well-planned educational activities.

Do men want to perform testicular self-examination?

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.

Testicular Cancer Preventive Behavior among Nursing Males' Students: Intervention Guidelines

Context: Testicular cancer is the most common form of urogenital cancers among young men aged between 20–40 years. The incidence of testicular cancer is rapidly increasing. It is highly curable when detected and treated early. &#x0D; Aim: This study aimed to evaluate the effect of intervention guidelines on preventive behaviors among nursing males' students.&#x0D; Methods: A quasi-experimental study conducted at the technical institute of Beni-Suef university through the academic year (2018-2019). A convenient sample of (250) student male nurses have included in this study. Tools of data collection were a self-administrated questionnaire; Champion Health Belief Model Scale; testicular self-examination checklist, and student follow up card.&#x0D; Results: The current study revealed a mean age of students was 18.45 ± 1.65. The study showed that there was a significant increase in the mean score of satisfactory knowledge about testicular cancer and its preventive behaviors during follow up post-application of the intervention guideline at (p=0.001). Furthermore, an improvement in the testicular self-examination practices at post-intervention and follow (p=0.001). A statistically significant correlation revealed between the student nurses knowledge, practice, and preventive health believes and behaviors.&#x0D; Conclusion: The study concluded that intervention guideline designed based on the health belief model has a positive effect on promoting testicular cancer-preventive behaviors of student male nurses by improving their knowledge, practices, and health beliefs and behaviors. The study recommended dissemination of intervention guidelines among males at a different stage of life started from adolescents to reduce the risk of testicular cancer and its consequences on males reproductive health. Integrate the concept of TSE as a screening procedure for early detection of testicular cancer and other testicular disorders into the undergraduate curriculum of nursing faculties. Further research required to investigate barriers influencing the practice of testicular self-examination among Egyptian males.

Aetiology, clinical presentation and treatment of testicular cancer.

Testicular cancer is a highly treatable and curable malignancy. It typically affects men aged 15-35 years and is the most common malignancy in this age group. Nurses have an important role in assisting patients to cope with the diagnosis and understand the treatment options. It is also important for nurses to provide psychological support, because testicular cancer can have a significant effect on a man's fertility, sexuality and body image. This article examines the epidemiology and aetiology of the disease, together with its clinical presentation and treatment options. It emphasises the importance of early detection of testicular cancer to improve its prognosis, through awareness of the signs and symptoms of the disease and undertaking regular testicular self-examination.

PD13-05 TESTICULAR CANCER AMONG INFERTILE MEN: A COST BASED RATIONALE FOR PROMOTING TESTICULAR SELF EXAMINATIONS

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I1 Apr 2017PD13-05 TESTICULAR CANCER AMONG INFERTILE MEN: A COST BASED RATIONALE FOR PROMOTING TESTICULAR SELF EXAMINATIONS Adithya Balasubramanian, Naveen Yadav, Edgar W. Kirby, Alexander W. Pastuszak, and Larry I. Lipshultz Adithya BalasubramanianAdithya Balasubramanian More articles by this author , Naveen YadavNaveen Yadav More articles by this author , Edgar W. KirbyEdgar W. Kirby More articles by this author , Alexander W. PastuszakAlexander W. Pastuszak More articles by this author , and Larry I. LipshultzLarry I. Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.693AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular cancer (TC) is the most common malignancy among men 15-34 years old, and infertile men are at increased risk for TC. Here, we investigate the costs of screening infertile men for TC, and the cost savings associated with early detection and treatment of TC among infertile men. METHODS Incidence, prevalence and hazard ratios for TC and infertility were extracted from the literature and used to calculate the annual number of TC cases among infertile men. Costs associated with TC screening and treatment were compiled using existing Medicare reimbursement databases and published data. These costs were used to model the costs of screening and treatment of infertile men at risk for TC. RESULTS Using incidence, prevalence and census data, the number of infertile men in the U.S. was calculated to be 2,350,000. Using co-prevalence data, 375 new cases of TC per year were estimated in the infertile male population. Screening using testicular self-examination (TSE) resulted in no cost burden. Prior to treatment, confirmation of the diagnosis of TC in men with testicular masses included tumor markers and scrotal ultrasound; these costs are folded into treatment costs. Early treatment was defined as radical orchiectomy followed by low-dose chemotherapy. Late TC treatment was defined as radical orchiectomy followed by chemotherapy and retroperitoneal lymph node dissection (RPLND), as well as salvage chemotherapy. The total cost associated with early treatment of infertile men diagnosed with TC using TSE was $7,035,394, in contrast with a total cost of $19,350,096 for late treatment of this population. Thus, the cost savings resulting from early detection of TC in infertile men using TSE is approximately $12,314,701 per year. CONCLUSIONS Infertile men are at increased risk for TC. We find that early screening for TC among infertile men via TSE can result in early TC detection and significant cost savings resulting from early treatment. Despite U.S. Preventive Services Task Force (USPSTF) recommendations against TSE, TSE among infertile men represents a cost effective means of early TC detection in this at risk population. © 2017FiguresReferencesRelatedDetailsCited byRichie J (2018) Re: Attitudes toward Testicular Cancer and Self-Examination among Northern Irish MalesJournal of Urology, VOL. 199, NO. 6, (1398-1399), Online publication date: 1-Jun-2018. Volume 197Issue 4SApril 2017Page: e272-e273 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Adithya Balasubramanian More articles by this author Naveen Yadav More articles by this author Edgar W. Kirby More articles by this author Alexander W. Pastuszak More articles by this author Larry I. Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Developing the "Control Identity" Typology to Create More Effective Testicular Health Promotional Messaging.

Testicular self-examination (TSE) promotional interventions historically operate without a theoretical framework, which negatively influences their effectiveness. As TSE is critical to the early detection of testicular cancer, this behavior is an essential component to improving overall male well-being. To address this need, the Control Identity personality typology was developed to assist in creating more effective TSE promotional interventions. Four outcome control dispositions were defined a priori based on the dimensions of illusions of control and locus of control. An original 41-item survey, the Control Identity Assessment Scale, was used to assess perceived vulnerability, value of health promotion, and health outcome control among a convenience sample of 300 university males aged 18 to 35 years via a cross-sectional research design. Factor and cluster analyses were employed to extract salient factors in the data and to identify subgroups within the sample. A consistent five-factor structure matrix (~70% explained variance) served as the foundation from which a k-means cluster analysis was employed to classify four types of individuals. Significant differences were detected between clusters on primary variables, including behavioral intentions to conduct TSE. The Control Identity typology aims to provide the needed mechanism for health practitioners to create more effective preventive health messaging to promote TSE. Future implications on employing this typology to segment audiences in order to increase overall effectiveness are offered. Application of this typology could ultimately lead to increasing TSE knowledge retention, behavioral intentions, actual performance, and adherence.

Testicular-self examination among Nigerian adolescent secondary school boys: knowledge, attitudes and practices.

Testicular-self examination (TSE) is a cheap and easy-to-perform procedure for early detection of testicular cancer but data on this subject is lacking in Nigeria, particularly among male adolescents. To assess the knowledge, attitudes and practices of testicular-self examination among secondary school boys. Knowledge, attitudes and practices in relation to TSE were assessed, using anonymous structured self-administered questionnaires in a sample of 540 secondary school boys aged between 15 and 20 years. Nearly all (98.7%) the male students had never heard of TSE and had hardly practiced TSE. Of the 7 students who admitted examining their testicles, none did so at the recommended level (10 or more times per year) and did not follow the standard procedure for TSE. Nearly half (47.2%) of the participants had a positive intention to start performing TSE regularly after hearing of TSE (through the questionnaire and subsequent teaching on the subject). The level of knowledge, practice and the rating of the importance of TSE are all very low among adolescent secondary school boys in Benin City, suggesting that these students are unaware of the value of this personal health surveillance tool. The students demonstrated a positive intention to start performing TSE regularly after hearing of TSE (through the questionnaire and subsequent teaching on the subject).

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

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 ...

Early detection of testicular cancer: revisiting the role of self-efficacy in testicular self-examination among young asymptomatic males

Research suggests that self-efficacy is an important factor in behaviors that facilitate the early-detection of various cancers. In general people with high self-efficacy are more likely to attend cancer screening sessions or perform bodily self-exams. However, there is a paucity of research focusing on testicular cancer and testicular self-examination (TSE). The effect of self-efficacy on TSE remains unclear especially given the relative obscurity of the testicular cancer threat, and appropriate clinical- and self-detection procedures, in the young asymptomatic male population. Thus, the present study tested the interaction of self-efficacy with young men's appraisals of the threat of testicular cancer. The study was based on 2 × 2 × 2 mixed factorial experimental design. Over 100 young asymptomatic men were exposed to a health warning about testicular cancer and randomly assigned to high/low self-efficacy, vulnerability, and severity conditions. High self-efficacy increased motivation to perform TSE given high vulnerability, but damaged attitudes to self-exams given low vulnerability and severity estimates. High self-efficacy also facilitated subsequent TSE. Overall, these findings support preexisting notions of self-efficacy but raise new questions about the moderating effects of threat appraisals.

Comprehension and Practice Patterns Toward Cryptorchidism in Korean Urologists

Purpose: We evaluated the practice patterns of urologists in Korea regarding the diagnosis and management of cryptorchidism. Materials and Methods: Self-completed questionnaires that consisted of 15 items concerning the diagnosis and treatment of cryptorchidism were distributed via letters or e-mail to 167 urologists who practiced in training hospitals in Korea. Responses were collected and analyzed statistically. Results: Responses were received from 89 urologists (response rate was 53.5%). Most of the urologists (96%) recommended that cryptorchidism be treated at the age of 1 year or before. In the case of postpubertal cryptorchidism, 72% of Korean urologists preferred orchiopexy first because of cosmesis (42%) and early detection of testicular cancer (38%). Sixty-five percent of all urologists preferred surgical correction of a retractile testis at the time of diagnosis or when the condition persisted until school age or puberty. Pediatric urologists were more conservative in terms of management of a retractile testis than were general urologists (p=0.009). To detect hidden testes in nonpalpable cryptorchidism, most urologists (92%) performed imaging studies, whereas only 39% of urologists performed laparoscopy. Conclusions: Korean urologists who practice in the training hospitals have a high level of understanding of the management of cryptorchidism. However, some differences of opinion exist in the diagnosis and treatment of nonpalpable undescended testis and retractile testis. These results can be used as baseline data for establishing future diagnosis and treatment guidelines for cryptorchidism. (Korean J Urol 2009;50:169-178) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

How Harmful is Contralateral Testicular Biopsy?—An Analysis of Serial Imaging Studies and a Prospective Evaluation of Surgical Complications

Objective: Testicular biopsy has recently gained a role in early detection of testicular cancer. However, its use is still limited mainly because of the fear of untoward consequences. There is a paucity of data regarding unfavourable effects of testicular biopsy. Therefore, we systematically looked to the consequences of the procedure by using clinical observational methods and by modern imaging techniques, respectively. Patients, methods: 1874 patients with testicular cancer enrolled in a nation-wide contralateral biopsy study were prospectively analyzed in regard to surgical complications. Serial scrotal imaging was performed by scrotal sonography (7.5 Mhz) in 55 patients and by magnetic resonance tomography (1.5 Tesla machine, surface coil, contrast media) in 60 patients, respectively. Imaging examinations were done preoperatively and again at 1 week, 6 months, 12 months, and 18 months respectively. Imaging results were tabulated according to an abnormality score and analyzed by descriptive statistics. Results: 52 patients (2.78%; 95% confidence intervals 2.05–3.60) experienced surgical complications. Forty minor complications were managed conservatively. Twelve patients (0.64%) required repeat surgery; 1 testicle was ultimately lost following a sequence of unfortunate events. No pre-existing clinical parameter was associated with complications. One week after surgery, abnormalities were detected in 33% by sonography and in 45% by MRI, respectively. Importantly, the abnormalities resolved in 96% of the cases, as found in both of the imaging modalities in the serial scans. Conclusions: Testicular biopsy is associated with a low burden of clinically significant complications. However, scrotal imaging discloses intratesticular abnormalities in a high proportion of cases one week after the biopsy. These changes represent focal haematoma, oedema or circumscript injury to vascular supply. Most of these lesions resolve with time and are thus not significant, clinically. Evidently, testicular biopsy is a safe procedure provided the vascular anatomy of the testis is respected upon surgery.

Carcinoma In situ of the testis: Review of biological and clinical features

Carcinoma in situ of the testis (CIS) is the uniform precursor of testicular germ-cell tumours. Morphologically, CIS consists of large, intratubular, gonocyte-like cells with large nuclei and abundant glycogen. CIS cells are probably derived from primordial germ cells and are supposed to be present in the testis of a future testis cancer patient at the time of birth. CIS cells appear to spread inside the seminiferous tubules until CIS progresses to invasive cancer. Diagnosis is best achieved by surgical biopsy of the testis and subsequent immunohistological staining of placental alkaline phosphatase (PlAP). This enzyme is present in embryonal germ cells, CIS and seminoma as well as several other types of germ-cell tumour but usually not in normal germ cells. CIS is found in testicular tissue adjacent to testicular germ-cell tumours in about 90% of cases, and it is observed in all clinical groups known to be at risk for testicular cancer: cryptorchidism (2% to 4%), infertility (0% to 1%), ambiguous genitalia (25%) and contralateral testis of patients with testicular cancer (5%). Conversely, CIS is found in less than 1% of the normal male population, and this prevalence corresponds well to the life-time risk of testicular cancer in males. If CIS is left untreated, there is a 50% probability of progressing to frank germ-cell neoplasm within 5 years. Localised low-dose radiotherapy to the testis eradicates CIS and germ cells, while Leydig cells are preserved. The patient can thus be spared orchiectomy and hormone supplementation. Currently, dose-reduction studies are looking for the optimal radiation dose, which is expected to be around 14 to 16 Gy. After chemotherapy, there is a cumulative risk of 42% for recurrence of CIS within 10 years. The concept of CIS offers the chance of very early detection of testicular cancer and organ-preserving early treatment. Int. J. Cancer 83:815–822, 1999. © 1999 Wiley-Liss, Inc.

Carcinoma in situ of the testis: review of biological and clinical features.

Carcinoma in situ of the testis (CIS) is the uniform precursor of testicular germ-cell tumours. Morphologically, CIS consists of large, intratubular, gonocyte-like cells with large nuclei and abundant glycogen. CIS cells are probably derived from primordial germ cells and are supposed to be present in the testis of a future testis cancer patient at the time of birth. CIS cells appear to spread inside the seminiferous tubules until CIS progresses to invasive cancer. Diagnosis is best achieved by surgical biopsy of the testis and subsequent immunohistological staining of placental alkaline phosphatase (PlAP). This enzyme is present in embryonal germ cells, CIS and seminoma as well as several other types of germ-cell tumour but usually not in normal germ cells. CIS is found in testicular tissue adjacent to testicular germ-cell tumours in about 90% of cases, and it is observed in all clinical groups known to be at risk for testicular cancer: cryptorchidism (2% to 4%), infertility (0% to 1%), ambiguous genitalia (25%) and contralateral testis of patients with testicular cancer (5%). Conversely, CIS is found in less than 1% of the normal male population, and this prevalence corresponds well to the life-time risk of testicular cancer in males. If CIS is left untreated, there is a 50% probability of progressing to frank germ-cell neoplasm within 5 years. Localised low-dose radiotherapy to the testis eradicates CIS and germ cells, while Leydig cells are preserved. The patient can thus be spared orchiectomy and hormone supplementation. Currently, dose-reduction studies are looking for the optimal radiation dose, which is expected to be around 14 to 16 Gy. After chemotherapy, there is a cumulative risk of 42% for recurrence of CIS within 10 years. The concept of CIS offers the chance of very early detection of testicular cancer and organ-preserving early treatment.

The value of the biopsy of the contralateral testis in patients with testicular germ cell cancer: the recent German experience.

Testicular intraepithelial neoplasia (TIN; so-called carcinoma in situ of the testis), the precursor of testicular germ cell neoplasms can be detected by testicular biopsy many years before the clinical manifestation of the tumour. This study looked at the prevalence of contralateral TIN in patients with testicular germ cell cancer. The purpose was to evaluate this new approach of early detection of testicular cancer and to evaluate the current management strategies. 1954 consecutive patients with unilateral testicular germ cell tumour underwent contralateral biopsy. All specimens were examined immunohistologically with staining for placental alkaline phosphatase. Patients with TIN were usually submitted to low-dose radiotherapy of the testis. A rebiopsy was performed after 3 months. Endocrinological evaluations were done before, during and after treatment. TIN was observed in 4.9% (95% confidence intervals 3.95%-5.91%). Testicular atrophy constitutes a 4.3 fold increased risk of having contralateral TIN. 64% of the cases with TIN were found in clinically normal testes. Patients with TIN were significantly younger than those without (p < 0.017). No case with TIN was found in patients older than 50 years. Three patients developed a second testicular tumour during follow-up despite a negative biopsy. After radiotherapy, all of 23 patients had complete disappearance of TIN in the rebiopsy. After chemotherapy, 3 of 10 patients had persistent TIN histologically. After radiotherapy, 12 of 41 patients required testosterone replacement. The prevalence of contralateral TIN accords well with the known prevalence of bilateral testicular tumours. Testicular atrophy is a strong indicator for the presence of TIN but about 60% of TIN-cases occur without atrophy. Local radiotherapy to the testis with 18-20 Gy is efficaceous in eradicating TIN, but it causes significant damage to almost one quarter of these patients. Chemotherapy is an unsafe treatment for TIN. This study shows the feasibility of early detection of testicular cancer in a high-risk population by means of searching for TIN. Although the management of the condition still needs refinement, the TIN-concept offers an avenue for the early detection of testicular cancer and early conservative management.