Delay in Diagnosis of Testicular Cancer; A Need for Awareness Programs

Abstract

Background AimTo gain insight into patient and doctor delay in testicular cancer (TC) and factors associated with delay.Materials and MethodsSixty of the 66 eligible men; median age 26 (range 17–45) years, diagnosed with TC at the University Medical Center Groningen completed a questionnaire on patients’ delay: interval from symptom onset to first consultation with a general practitioner (GP) and doctors’ delay: interval between GP and specialist visit.ResultsMedian patient reported delay was 30 (range 1–365) days. Patient delay and TC tumor stage were associated (p = .01). Lower educated men and men embarrassed about their scrotal change reported longer patient delay (r = -.25, r = .79 respectively). Age, marital status, TC awareness, warning signals, nor perceived limitations were associated with patient delay. Median patient reported time from GP to specialist (doctors’ delay) was 7 (range 0–240) days. Referral time and disease stage were associated (p = .04). Six patients never reported a scrotal change. Of the 54 patients reporting a testicular change, 29 (54%) patients were initially ‘misdiagnosed’, leading to a median doctors’ delay of 14 (1–240) days, which was longer (p< .001) than in the 25 (46%) patients whose GP suspected TC (median doctors’ delay 1(0–7 days).ConclusionsHigh variation in patients’ and doctors’ delay was found. Most important risk variables for longer patient delay were embarrassment and lower education. Most important risk variable in GP’s was ‘misdiagnosis’. TC awareness programs for men and physicians are required to decrease delay in the diagnosis of TC and improve disease free survival.

Potential factors associated with clinical stage of nasopharyngeal carcinoma at diagnosis: a case–control study

“…A patient interval of 3 months or longer was associated with a late diagnosis of NPC, which agreed with the findings of similar studies in which physical examination and knowledge about early symptoms played important roles in reducing the patient interval and promoting diagnosis at an early stage [ 36 , 37 ]. In the present study, physical examination was also associated with early NPC diagnosis.…”

The awareness of testicular cancer among young males in the Lubelskie Region / Świadomość nowotworu jądra wśród młodych mężczyzn na Lubelszczyźnie

“…The study by Öztürk confirmed that the relationship between one's education and tumor detection is more significant than in case of age or financial status. The second important reason is the embarrassment which restrains patients from consulting the doctor [16]. In the current study the ambivalent approach of the respondents was revealed.…”

“…Potwierdza to analiza Öztürka, która wykazała, że niski poziom edukacji ma większy wpływ na opóźnienie diagnozy w porównaniu z czynnikami takimi jak wiek czy status materialny. Drugi istotny powód wskazany przez Öztürka to onieśmielenie przyczyniające się do odwlekania konsultacji potencjalnych zmian chorobowych z lekarzem [16]. W badaniu na grupie populacji lubelskiej wykazano mieszany stosunek respondentów do tej tematyki.…”

From ‘D’ to ‘I’: A critique of the current United States preventive services task force recommendation for testicular cancer screening

“…The USPSTF (2011) states that males typically detect TCa unintentionally or through self/partner examination. Other research suggests that the best outcomes for TCa treatment stem from cases treated in earlier stages of the disease (see Saab et al, 2014 , Gilligan, 2015 , Öztürk et al, 2015 ). It would therefore be logical to assume that TSE or clinician examination promotes optimal wellness within this population.…”