Public awareness

Despite the controversy regarding physician-conducted screening and TSE, there seems to be a consensus that increased awareness about tes-ticular cancer among young men is necessary [66]. Those who advocate TSE programs must be mindful that these cannot succeed unless education and awareness can impart a value to the behavior. Numerous recent studies have demonstrated that young men generally are ignorant regarding testicular cancer and TSE (Table 3). On average, less than two thirds of young men had ever heard of testicular cancer and only approximately one third knew that it primarily affects young men. Less than one third were aware of TSE, and less than 10% perform TSE [38,43,62,63,67-75]. Most of these studies were of college and graduate students, implying that the general population knows little or nothing about this disease [38,67-69]. The largest survey of more than 7,000 European students found that 87% never practiced TSE and only 3%

Table 3

Knowledge of testicular cancer among young people

Table 3

Knowledge of testicular cancer among young people

Study

No. of subjects

Ever heard of testicular cancer (%)

Aware that young men Aware of are at risk (%) TSE (%)

Aware that testicular Practice of cancer usually is TSE (%) curable (%)

Conklin et al [43]

90

25

NS

0

0

NS

Cummings et al [67]

266

NS

42

16

5

NS

Goldenring and Purtell

147

NS

13

9.5

6

NS

[38]

Thornhill et al [68]

365

68

13

8

1.3

14

Blesch [69]

129

61

NS

31

9.5

NS

Reno [70]

126

NS

NS

13

9.5

NS

Dachs et al [63]

633

NS

57

39

4.7

NS

Klein et al [71]

66

47

15

23

1.5

NS

Raghavan [72]

80

<15

10

NS

NS

NS

Pendered [73]

Men, 79

63

29

35

27

59

Women, 96

72

50

48

82

Sheley et al [62]

415

NS

30

NS

16

NS

Singer et al [74]

717

NS

30

30

8

6

Wardle et al [75]

7,304

NS

NS

NS

9

NS

Abbreviation: NS, not stated.

Abbreviation: NS, not stated.

reported regular monthly TSE [75]. Even among health care providers, knowledge is lacking. Stanford [54] found that almost one half of female nurses were not familiar with TSE, and only 5% had taught a patient TSE, although almost two thirds believed it to be part of their job.

Regarding knowledge of signs and symptoms of testicular cancer, Cummings and colleagues [67] also found that more than half of the young men in their study could not identify any correct signs or symptoms of testicular cancer (lump, swelling, enlarged and heavy testis, and pain). Similarly, Thornhill and colleagues [68] found 72% of young men had no knowledge of possible symptoms and actually noted many incorrect symptoms, such as problems with potency or micturition. In one study, young women knew more about testicular cancer than did men of similar age [73].

There are several patient-education brochures available that discuss not only TSE but also the general facts regarding this cancer. These materials are available from the American Cancer Society [57], the National Cancer Institute [58], the American Urological Association [76], and commercial sources [77].

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