Timely Diagnosis of Testicular Cancer

Division of Urologic Surgery, Duke Prostate Center, Duke University Medical Center,

Durham, NC, USA

Screening for testicular cancer, like any true disease-screening effort, involves evaluation of an asymptomatic population for the disease in question. The goal of any cancer screening effort is to diagnose the disease at an early, more easily treatable stage with the ultimate goal of improving the disease-specific survival and minimizing treatment morbidity. Screening efforts can also be directed toward population groups most at risk for the disease to improve cost effectiveness, which is becoming increasingly important as we face the aging of the "Baby Boom'' generation.

Although testicular cancer is an uncommon neoplasm, it is the most common solid tumor in men between the ages of 20 and 34, and the incidence is increasing [1]. Because of the known and continuing problem of delayed diagnosis, which is discussed later, screening might be considered for this disease. Conversely, with most patients now being cured, the screening goal of increasing disease-specific survival may be impossible to improve substantially. The goal of early detection to minimize morbidity of treatment may be an obtainable goal.

Particularly relevant to testicular cancer is the concept of true screening of an entire asymptomatic population versus case finding in at-risk or symptomatic men. Akin to case finding is the concept of testicular self-examination (TSE) and increasing awareness of this disease among young men.

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