Health News Review

In all the years I’ve written about promotions for various screening tests, I’ve seen some oddities.

But those might pale in comparison with the various hairy testicle creatures roaming various regions of the earth.

Mr. Balls, aka ‘Senhor Testiculo,’ goes to bat for cancer research – reported the New York Daily News.

The Mirror reported on Mr. Balls, calling it a “cuddly testicular cancer mascot.”

The Fox News Latino website posted this picture.

 

TheLip.TV posted the video below, providing background on Irish and British competitors to Senhor Testiculo. In England, a man named Patrick Cox (no joke) who wears a testicle suit in the UK to promote testicular cancer awareness. He has said: “Our aim is to educate young men about the need to check themselves for testicular cancer.” He runs the Male Cancer Awareness Campaign.

 

 

However, there’s something missing from all of these cutesy, chuckling promotions.

Evidence.

Any implied endorsement of testicular screening, including self-examination – and it’s clear that such screening is endorsed by such campaigns – is not supported by evidence-based guidelines.

The US Preventive Services Task Force recommends against screening for testicular cancer in adolescent or adult males. It states:

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.

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.

Now, I can hear it off in the distance coming my way already……

….”You would be singing a different tune if you had testicular cancer. As the mother of a young man who survived I think it is interesting how many people don’t know about testicular cancer. Your point is really ridiculous.”

…“Shame on you for belittling the importance of men’s cancers…We are supposed to be encouraging men to speak to their doctors about these issues, and not shrouding them in complacency!”

Those two comments were actually written to Andre Picard after his piece in The Globe and Mail, “Sack the hysteria:  Men’s shorts aren’t filled with cancer time bombs.

You might also want to read a doctor’s piece in the BMJ entitled, “Routine testicular self examination: it’s time to stop,” in which he wrote about “campaigns that succeed only in turning the nation’s blokes into ball watching neurotics.”

To try to educate people about the evidence for benefit and harm from screening tests is not an anti-screening message. It’s not ridiculous. And it’s not belittling the importance of men’s cancers.  So let’s dispense with any rhetoric that makes such claims. (And be advised: I’m not going to provide a forum for it in the comments section.)

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Comments

Michael Benjamin posted on January 11, 2014 at 2:22 am

I thought of another reason why these mascots and whatnot are disagreeable: they make a joke out of something that isn’t really funny. Isn’t it a little infantile to construct a mascot out of scrotum? Really, that’s the best idea someone had to promote awareness about testicular cancer?
I felt a vague distaste about the whole “I heart boobies” bracelets that went around a few years ago. I have treated breast cancer as an oncologist year in and year out for a decade. It’s a difficult disease. We are making progress, but it’s agonizingly slow. Some of the patient stories are so tragic it’d take your breath away. It’s certainly not a joke, and not really a great context for that word.
Can we say that there’s something exploitational about producing a joke mascot around a disease? Exploitation is a strong word, but perhaps it conveys some of what’s wrong with these campaigns.
By the way, I didn’t have the same problem with the walk-through colon tunnel idea. To me it seemed like a creative way to help people understand their bodies. We have, in LA, the California Science Center, which has a great human body section. That colon display would fit right in there. http://doctormichaelbenjamin.com