Self-checking for testicular cancer is based on 'well-meaning whimsy': Doctor claims futile campaigns put unnecessary strain on hospitals… and men
11:13 GMT, 6 April 2012
For years, men have been encouraged to self-check themselves for testicular cancer – spurred on by Government campaigns and ads featuring celebrities such as Robbie Williams and sports stars.
But according to Dr Keith Hopcroft, a GP from Essex, such 'gonad groping' is not only a waste of time, it also a waste of resources.
He said that 'celebrity exhortations' to be 'testicle aware' might cause anxiety in those who have relatively common cysts and swellings.
And this in turn may lead to unnecessary ultrasound testing and longer waiting times for those in genuine need of further monitoring.
‘It’s easy for the profession and the public to get carried away with earnest health promotion dressed up as fun and assume that routine testicular self-examination is self-evidently A Good Thing,' he wrote in the British Medical Journal last week.
Self-testing may lead to unnecessary ultrasound scans and longer waiting times for those in genuine need of further monitoring, according to Dr Keith Hopcroft. Above, models Nancy Sorrell and Marco during the launch of the 'Check his Plums' campaign in 2004
He added: 'The trouble is, it isn’t. It’s an activity based purely on well-meaning whimsy, with the potential to do harm.
‘The chances of discovering something significant from a routine examination of the testicles are minuscule – at least 50,000 men would need to examine themselves for ten years to prevent one death.’
The doctor admitted that his opinions have caused 'quite a lot of anger' in the past.
In an article from the Mail several years ago, he said: 'We are constantly told that men should routinely examine their testicles for lumps and bumps, and they shouldn't be surprised if their GP asks to check them, too.
'On the face of it this seems to make perfect sense. Testicular cancer is the most common type of malignancy in young men, a group notorious for neglecting their health and avoiding doctors.
Dr Hopcroft said that 'celebrity exhortations' to be 'testicle aware' might cause anxiety in those who have relatively common cysts and swellings. Above, Robbie Williams in one such ad campaign
'It's easy to get carried away with earnest health promotion dressed up as fun,' the doctor wrote in the British Medical Journal. Above (l to r) David James, Greg Rusedski, Gavin Henson and Matthew Stevens in a charity ad
DO NO HARM: DR HOPCROFT'S VIEW ON TESTICULAR CANCER
Keith Hopcroft's thoughts on self-testing were outlined in a Mail Online article several years ago, an extract of which is below:
A man examining his testicles for
lumps is quite likely to find some non-malignant part of his genital
anatomy he has never previously noticed.
The result is stress, an eventual courageous visit to the doctor, the possibility of unnecessary tests and more anxiety while he waits for the results.
The huge glare of publicity
surrounding testicular examination has the potential to turn a trickle
of men who've always tended to remain healthily cautious into a flood of
What evidence there is fits with the impression that, as a screening test, self-examination is lousy: most researchers in the field say it isn't worthwhile and many go so far as actively to discourage it.
There's no doubt that men's health
is long overdue proper media and medical attention. The problem is that
the genital fixation may backfire badly.
Quite apart from having no good
scientific basis and the potential to create unnecessary worry,
promoting testicular screening may simply discourage men from attending
Serious delays in diagnosis are
linked to the ways men behave – the problem is not a failure to notice
symptoms but a reluctance to do anything about them.
There's also the danger that this
focus on testicular cancer will portray the disease as more evil than it
really is. In fact, it is very treatable and often curable – in 90pc of
Treatment is possible for all
patients – and even those in whom the cancer has spread dramatically can
end up with a clean bill of health.
So let's shout about men's health.
Let's make men more aware of symptoms; make visits to the doctor more
acceptable and less intimidating; make the NHS man-friendly. But let's
not scare them witless or scare them away.
Men should be able to keep their
privates private and doctors should recall that one of the most
fundamental ethical duties governing medicine is 'Primum non nocere' –
first, do no harm.
'And, of course, it's crucial to seek medical advice swiftly if there's even an inkling that something's untoward.
'But there's just one problem: routine examination of the testicles to detect cancer, whether by doctor or patient, simply doesn't work. Worse than that, it may cause harm.
'Testicular cancer is, thankfully, rare. The average male has an annual risk of developing the disease of about one in 25,000 and the average GP can expect to see one new case every 15 years.'
'Besides, the disease isn't usually “silent”: unlike the cervix, which tends to go through pre-cancerous changes requiring detection through smears, the testicle usually announces the presence of a cancer with obvious symptoms such as aching, heaviness or swelling.
'So the chances of a man or his doctor fumbling across an unsuspected testicular cancer are minuscule.'
However, the Government and cancer charities do not agree with his standpoint.
A Department of Health spokeswoman said: ‘The current advice is that the best way to check for testicular cancer is to examine yourself once a month, preferably after a bath or shower.
‘Men should be aware of any unusual changes and consult doctors early in order to ensure the maximum chance of a cure and reduce their chance of more intensive treatments.’
Meanwhile, Hazel Nunn, head of health information at Cancer Research UK, told Metro newspaper: ‘It’s a good idea to get to know your body so you notice any changes and can report them promptly to your doctor.
'Changes to your testicles are no exception.
‘Survival rates for testicular cancer are excellent, but finding the disease early is likely to lead to more straightforward treatment.’
Dr Hopcroft told the paper: ‘I’ve had letters and emails that have virtually implied I’m wishing cancer upon men, which is an odd thing to do considering I’m a man and I have two sons.
‘I’ve also got a family member who’s had testicular cancer, so why would I do that
The doctor, who is also an editorial adviser at Pulse, a magzine for GPs, insisted he did not have an issue with men monitoring their testicles for signs of cancer.
He said he disapproved of the media constantly nagging men to ritualistically check themselves because there is 'no evidence that it is a good idea'.