Assessing Levels of Evidence for Cancer Screening: A Focus on Testicular Self-examination.

Authors

Kamalie Thomas, Ashley Malvita, Michael J Rovito

Published in

Cancer prevention research (Philadelphia, Pa.). Volume 19. Issue 10. Pages 559-563. Oct 01, 2026.

Abstract

Testicular cancer is the most common malignancy among men 15 to 45 years of age, with 5-year relative survival exceeding 95% when all stages are combined. Early detection may reduce treatment intensity, preserve fertility, and protect quality of life. Testicular self-examination (TSE) has historically been recommended as a secondary prevention strategy; however, the US Preventive Services Task Force issues a D recommendation against routine TSE, citing insufficient evidence of mortality benefit and potential harms. The National Cancer Institute Physician Data Query (PDQ) levels-of-evidence framework offers a complementary approach, grading certainty of effects while decoupling evidence assessment from prescriptive policy. This article contrasts the 2 frameworks, examines the available evidence for TSE, and considers whether elements of the PDQ approach could usefully inform guidance for low-incidence, high-survivability cancers. We argue that current evidence does not support a strong recommendation for or against routine TSE, but that mortality-only frameworks may understate outcomes that matter to patients, including treatment burden, fertility, and psychosocial function, and that more transparent communication of uncertainty would better support shared decision-making.

PMID:
42817620
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.