Fathers World: Health and Fitness

Should I be screened for testicular and prostate cancers?

Screening for a disease involves examining and testing people who have no symptoms (asymptomatic). The theory behind screening is that early detection of the disease will improve the outcome of those affected by it. In order for a screening to be effective, there are certain qualifications that need to be met: There needs to be a significant prevalence of the disease.

The tests used to detect the disease need to be relatively inexpensive and tolerable to the population being tested. The tests need to be reliable and accurate in detecting the disease. An ideal test would be positive only in those with disease and negative in those without. In reality, no test is ideal, and some people with disease will go undetected, and some without will be falsely positive. Finally, the disease being screened for must be one in which early detection will have a significant positive impact on treatment and curability. Hypertension (high blood pressure) is an excellent example of a disease for which screening is beneficial. Many people have hypertension (more than 30 percent of people over 50). It is essentially asymptomatic in the early stages. Testing blood pressure is simple to perform; it is non-invasive, extremely inexpensive and fairly reliable. And most importantly, early treatment of hypertension with lifestyle changes clearly reduces risk of heart attack, stroke and kidney failure.

Testicular cancer is a relatively uncommon disease. Approximately 6,000 men are diagnosed each year. Still, it is the most common cancer in men between the ages of 15 and 35. Prior to 1980, men in an advanced stage of the disease had a very low rate of survival. However, early detection allowed for a high chance of cure. Since 1980, treatments have improved such that even people in advanced stages of testicular cancer have a good chance of being cured. All men under the age of 40 should periodically check themselves for an unusual testicular mass. At yearly or biannual physical exams, a physician should also feel for any masses. These are inexpensive, easy to perform and generally well-tolerated tests for asymptomatic cancer. Most patients present with an asymptomatic nodule or swelling in a testicle.

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