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U.S. Panel Still Opposes Testicular Screening

September 22, 2010
Written by: , Filed in: Abdominal Imaging
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The U.S. Preventive Services Task Force, in a draft statement published Tuesday, reaffirmed its longstanding recommendation against routine screening for testicular cancer.

Ultrasound would be the method of choice for such screening. The stance against it is not likely to spark the sort of uproar that followed the same panel’s decision last year not to recommend routine mammograms for women in their 40s. (The task force describes itself as “the leading independent panel of private-sector experts in prevention and primary care.” It advises the Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services.)

The draft recommendation, published on the task force’s Web site, is up for public comment through October 19. It reaffirms the panel’s 2004 recommendation against screening.

The panel said that, though testicular cancer is the most common cancer among men ages 15 to 34, it’s still relatively rare, with an annual rate of 5.4 cases per 100,000 men. “Based on the low incidence and favorite outcomes of treatment, even in cases of advanced testicular cancer,” the panel said, “there is adequate evidence that the incremental benefits of screening for testicular cancer are small to none.”

The task force reviewed studies published from 2001 through 2009. It found none that directly addressed the benefits of screening. One study did look at 1,320 patients who received ultrasound examinations after experiencing testicular or scrotal symptoms. Only 27 had testicular cancer. The task force concluded that screenings of asymptomatic populations would reveal very few unsuspected cases.

One small study did point to the XIST gene, which deactivates the X chromosome and thus is normally methylated in men, as a possible marker for the disease. The researchers tested 25 patients with testicular cancer and 30 with either other types of cancer or no cancer. The study found that 16 of the 25 testicular-cancer patients had unmethylated XIST genes. None of the other patients did. Considerable follow-up research would be needed to establish whether an XIST test could be a useful screening tool.

Related seminar: Imaging Advances: Abdominal, Thoracic, Skeletal (new release)

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