Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

Tests are used to screen for different types of cancer when a person does not have symptoms.

Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.

The testicles are 2 egg-shaped glands inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord. The spermatic cord also contains the vas deferens and vessels and nerves of the testicles.

The testicles are the male sex glands and make testosterone and sperm. Germ cells in the testicles make immature sperm. These sperm travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles). This is where the sperm mature and are stored.

Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas.

Testicular cancer is the most common cancer in men aged 15 to 34 years.

Testicular cancer is very rare, but it is the most common cancer found in men between the ages of 15 and 34. White men are four times more likely than black men to have testicular cancer.

A condition called cryptorchidism (an undescended testicle) is a risk factor for testicular cancer.

Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk. Risk factors for testicular cancer include the following:

• Having cryptorchidism (an undescended testicle).
• Having a testicle that is not normal, such as a small testicle that does not work the way it should.
• Having testicular carcinoma in situ.
• Being a White man.
• Having a personal or family history of testicular cancer.
• Having Klinefelter syndrome.

Men who have cryptorchidism, a testicle that is not normal, or testicular carcinoma in situ have an increased risk of testicular cancer in one or both testicles, and need to be followed closely.

Importance

Testicular cancer (a primary germ-cell tumor of the testis) is the most common cancer among males aged 15 to 34 years. However, with an annual incidence rate of 5.4 cases per 100,000 males, testicular cancer is relatively rare compared with other types of cancer.

Detection

Most cases of testicular cancer are discovered accidentally by patients or their partners. There is inadequate evidence that screening by clinician examination or patient self-examination has a higher yield or greater accuracy for detecting testicular cancer at earlier (and more curable) stages.

Benefits of Detection and Early Intervention

Based on the low incidence of this condition and favorable outcomes of treatment, even in cases of advanced disease, there is adequate evidence that the benefits of screening for testicular cancer are small to none.

Harms of Detection and Early Intervention

Potential harms associated with screening for testicular cancer include false-positive results, anxiety, and harms from diagnostic tests or procedures. The USPSTF found no new evidence on potential harms of screening and concluded that these harms are no greater than small.

USPSTF Assessment

The USPSTF concludes that there is moderate certainty that screening for testicular cancer has no net benefit.

Patient Population Under Consideration

This recommendation applies to asymptomatic adolescent or adult males. The USPSTF did not review the evidence for screening males with a history of cryptorchidism.

Screening Tests

The sensitivity, specificity, and positive predictive value of testicular examination in asymptomatic patients are unknown. Screening examinations performed by patients or clinicians are unlikely to provide meaningful health benefits because of the low incidence and high survival rate of testicular cancer, even when it is detected at symptomatic stages.

Treatment

Management of testicular cancer consists of orchiectomy and may include other surgery, radiation therapy, and chemotherapy, depending on the disease stage and tumor type. Regardless of disease stage, more than 90% of all newly diagnosed cases of testicular cancer will be cured.

There is no standard or routine screening test for testicular cancer.

There is no standard or routine screening test used for early detection of testicular cancer. Most often, testicular cancer is first found by men themselves, either by chance or during self-exam. Sometimes the cancer is found by a doctor during a routine physical exam.

No studies have been done to find out if testicular self-exams, regular exams by a doctor, or other screening tests in men with no symptoms would decrease the risk of dying from this disease. However, routine screening probably would not decrease the risk of dying from testicular cancer. This is partly because testicular cancer can usually be cured at any stage. Finding testicular cancer early may make it easier to treat. Patients who are diagnosed with testicular cancer that has not spread to other parts of the body may need less chemotherapy and surgery, resulting in fewer side effects.

If a lump is found in the testicle by the patient or during a routine physical exam, tests may be done to check for cancer. Some tests have risks, and may cause anxiety.

Men should check their testes each month starting in their teen years. Cancer of the testes can often be cured if found early.

Steps

1. After taking a warm bath or shower, stand in front of a mirror. Look for any swelling of the skin around the testes.
2. Use both hands to feel each testicle – one at a time. Place your fingers under each testicle with your thumbs on top.
3. Roll each testicle gently between your thumbs and fingers. Feel for any lumps. You should not feel any pain as you do this. You will feel a soft tubelike structure behind the testicle, which stores and transports sperm. Repeat on the other side.

See your doctor right away if you have:

• A lump
• A testicle that becomes larger or shrinks
• A feeling of heaviness or a large amount of fluid in the skin around the testes

Testicular cancer can usually be cured.

Although the number of new cases of testicular cancer has doubled in the last 40 years, the number of deaths caused by testicular cancer has decreased greatly because of better treatments. Testicular cancer can usually be cured, even in late stages of the disease.