Cancer checks 'a waste of time'

Cancer checks 'a waste of time'. Over the past 20 years, the number of reported cases of testicular cancer in Britain has doubled, to 1,400 a year. It is the commonest form of cancer in young men and is treatable is caught early.

Here Dr Keith Hopcroft reveals his controversial view on checking and screening for the cancer . . .

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. 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.

What is more, 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 cancer-fearing neurotics.

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 the doctor.

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 cases.

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 even 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. ( dailymail.co.uk )

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