What are the screening guidelines for testicular cancer?

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The purpose of screening is to detect conditions before they have shown any obvious symptoms. However, there is some disagreement about routine screening guidelines for testicular cancer.

According to the American Cancer Society (ACS), most doctors agree examining the testicles should be part of a routine checkup.

However, there is little evidence that this practice is beneficial. For instance, a 2022 review states that within a screening context, neither testicular exams nor ultrasonography screenings have demonstrable positive effects on mortality.

The main reason for this is that treatment for testicular cancer is highly effective, even in the later stages of the condition.

It is possible that some individuals with the disease could benefit from screening, as an earlier diagnosis may translate to less treatment.

However, screening procedures for testicular cancer can be uncomfortable, time-consuming, and expensive. It could also lead to unnecessary surgical procedures, such as testicle resection.

Therefore, scientists do not know whether the advantages of testicular cancer screening outweigh the drawbacks.

There are no universally accepted routine screening guidelines for testicular cancer.

This remains true even for people with an increased risk of developing this condition. According to the above 2022 review, these individuals include:

• being white
• having certain conditions, such as
  • undescended testicles
  • gonadal dysgenesis — a congenital condition that affects how the gonads develop
  • Klinefelter syndrome — a genetic condition that affects the development of the testes
• having a family history of testicular cancer

It is worth emphasizing that people within these at-risk groups will not necessarily develop testicular cancer. However, they may wish to be extra vigilant about knowing the signs and symptoms of the disease.

According to the ACS, doctors may use a variety of techniques for diagnosing testicular cancer. They may also use these methods to monitor the progression of someone’s testicular cancer or check for any spread.

These techniques include:

• testicular ultrasonography
• other imaging tests, including X-rays, MRI scans, and PET scans
• tumor marker blood tests

Doctors typically do not use biopsies to diagnose testicular cancer. This is because the above methods are typically sufficient for diagnosis. Moreover, a biopsy can sometimes spread cancer to other locations.

It may be possible for some people to request testicular cancer screening from a healthcare professional.

However, due to the lack of evidence for the efficacy of these screenings, some doctors may advise against this.

Furthermore, some healthcare professionals may lack the resources to provide this test, as it is seemingly inessential.

Anyone considering screening for testicular cancer should discuss this with a doctor first.

Some doctors recommend that individuals with testicles routinely perform testicular self-exams. The purpose of these is to find any atypical testicular growth, or testicular lumps.

The ACS provides guidance on performing testicular self-exams. It is best to perform the exam during a bath or shower. An individual should take the following steps:

• Step 1: Hold the penis out before separately examining each testicle.
• Step 2: Hold each testicle between the fingers and thumb.
• Step 3: Gently roll it between the fingers.
• Step 4: Feel for any changes in testicle size or texture or for hard nodules or lumps.

It is unclear whether testicular self-exams do much to improve the outlook of those with this condition. For this reason, the ACS does not have specific recommendations on how often to perform these exams.

Testicular cancer can remain asymptomatic for some time. However, it can also present with some clear symptoms.

The ACS lists the following as signs of early stage testicular cancer:

• a lump forming on a testicle
• a testicle swelling or becoming larger
• testicular pain
• sometimes, breast soreness or growth
• early puberty, in younger individuals

If someone’s testicular cancer spreads to other locations, it can present differently. The following are signs of later stage testicular cancer:

• abdominal pain
• lower back pain
• shortness of breath, coughing, or chest pain
• confusion or headaches

Importantly, many other conditions have overlapping symptoms with testicular cancer. For instance, signs of earlier stage testicular cancer can also arise from infection or injury to the testicles.

An individual should contact a doctor straight away if they show signs of testicular cancer. This is especially true of people with an increased risk of developing this condition.

An earlier diagnosis could mean a person needs fewer treatments, which may also be more effective.

There is strong evidence for the efficacy of testicular cancer treatment. For instance, research shows that the cure rate for the disease is around 90% and the 5-year survival rate is over 95%.

Testicular cancer is a type of cancer affecting males aged 15 to 45 years.

Screening for this condition is controversial, as no universally accepted guidelines exist. Although many doctors believe routine checkups should involve testicular exams, little evidence suggests they are beneficial.

People with a higher risk of developing testicular cancer, such as those with certain conditions or a family history of the disease, may want to be extra vigilant.

Signs of the disease include testicular pain, swelling, and lumps. Testicular self-exams may help people spot those symptoms early.

Doctors typically diagnose testicular cancer using imaging tests and blood tests. It is uncommon for them to use biopsies for this purpose.