Mr. Balls, Senhor Testiculo, and a man named Cox

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

• A porn star and the “Boob Bus Nurse Brigade” promoting mammography
• A fun-filled giant walk-through colon to promote colorectal cancer screening

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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