The United States Preventive Services Task Force (USPSTF) recently published its updated guidelines on testicular cancer screening and offered a reaffirmation of their previous recommendations from 2004.
With regard to screening for testicular cancer in asymptomatic males, the USPSTF recommendation states that there is inadequate evidence to suggest that screening via either self-examination or clinician examination has a greater yield for detection of testicular cancer. Therefore, this organization recommends against routine screening, as there is no evidence that such screening offers any net benefit, given a low incidence of testicular cancer and excellent treatment outcomes for detected cases. Similarly, these recommendations have been endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Cancer Society.
Testicular cancer remains one of most rare forms of cancer in men worldwide, yet is the most common cancer in men ages 15 to 34 years. In the US, the annual incidence is estimated at 5.4 cases per 100,000 men. Most cases of testicular cancer continue to be discovered by young men “accidentally”, or by their sexual partners.
Potential harms associated with screening for testicular cancer include the notion of false-positive results, the creation of significant anxiety and worry in men, and potential unintended harms from diagnostic tests or procedures.
Making a statement to recommend against screening for testicular cancer has led to much debate and concern among clinicians, despite a lack of strong evidence to suggest otherwise. Some clinicians have interpreted this statement as discouragement of patients seeking medical attention for testicular or scrotal symptoms, yet this notion breaches the definition of routing screening, and is not part of the explicit recommendation.
Reference: U.S. Preventive Services Task Force. Screening for Testicular Cancer: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. Ann Intern Med 2011;154:483-6.