Mohamad M. Saab

Testicular Cancer Awareness and Screening Practices: A Systematic Review

PURPOSE/OBJECTIVES To critically appraise empirical evidence gathered from studies that (a) explored mens knowledge, awareness, and attitudes toward testicular cancer (TC) and its screening; (b) addressed their testicular self-examination (TSE) practice; and/or (c) highlighted barriers and facilitators to this practice.
. DATA SOURCES MEDLINE®, CINAHL®, and EMBASE®.
. DATA SYNTHESIS 25 articles met the inclusion criteria. Knowledge deficits regarding TC and its screening were seen. Participants who did not perform TSE often were uninformed about this practice. The majority of men perceived TC education as a positive step toward raising awareness about this malignancy.
. CONCLUSIONS Very few men were informed about TC and TSE. Future studies should include valid and reliable tools to assess TC knowledge and screening, address the means through which TC knowledge is delivered, explore the individuals experience with TC screening, and focus on TC awareness and screening among minority groups. 
. IMPLICATIONS FOR NURSING Although regular screening for TC is a controversial issue, nurses should encourage young men to seek medical attention in the event of discovering scrotal abnormalities.

Promoting Testicular Cancer Awareness and Screening: A Systematic Review of Interventions.

Background: Testicular cancer (TC) is a relatively curable malignancy that predominantly affects young males. Key decision makers discourage TC screening because of lack of evidence about the benefits of this practice, whereas others argue that men must be aware of normal versus abnormal testicular findings. Despite the debate on TC surveillance, a number of research efforts are still being made to increase men’s awareness of TC and its screening. Objective: The aim of this study was to systematically review studies that were conducted to enhance men’s knowledge and awareness regarding TC and its screening and increase their TC screening intentions and practices. Methods: Studies published in English between 2004 and 2014 were reviewed using 3 e-databases, and interventions that were in line with the review aims were selected. Results: A total of 3076 records were screened for eligibility, and 11 studies met the inclusion criteria. The majority of the reviewed interventions successfully enhanced men’s awareness of TC and its screening and increased their intentions to perform testicular self-examination. Examples include videos about TC, shower gel sachets, stickers, and posters, a television show, a university campaign, and high self-efficacy messages about TC screening. Men at risk of health disparities were underrepresented in the reviewed literature. Conclusions: A number of interesting channels through which men can learn about TC were identified. Examples include social media and mass media. Implications for Practice: Given the controversy that surrounds TC screening, nurses can play a key role in increasing men’s awareness of TC rather than advising periodical TC self-examination.

Men's information‐seeking behavior regarding cancer risk and screening: A meta‐narrative systematic review

Preventive strategies are known to reduce cancer risk and incidence and improve prognosis. Men seldom seek medical information about cancer prevention and risk reduction. The aim of this meta‐narrative systematic review was to critically appraise evidence from qualitative, quantitative, and mixed‐methods studies that explored mens information‐seeking behaviors in relation to cancer prevention and risk reduction.

Males' Awareness of Benign Testicular Disorders: An Integrative Review.

Disorders that affect the testes can range from painless and benign to debilitating and life threatening. Despite the availability of literature on the etiology, diagnosis, and treatment of benign testicular disorders (BTD), very little is known about men’s awareness of these conditions. The aim of this review was to extract and analyze evidence from studies that explored males’ awareness of BTD. Four e-databases (CINAHL, MEDLINE, PsychINFO, and PubMed) were thoroughly searched and four articles met the review inclusion criteria. The quality of the included studies was appraised and data were extracted and cross-checked using a standardized data extraction table. It was determined that participants lacked education about testicular self-examination and scrotal signs and symptoms which contributed to their lack of awareness of BTD. Help seeking in the event of scrotal abnormalities was suboptimal which is alarming given the acuteness of some BTD such as testicular torsion. Individuals who are at risk for health disparities were underrepresented in the reviewed literature. Findings from this review highlight the need to address barriers to BTD knowledge and help seeking. This could be achieved through making use of past interventions that succeeded in increasing men’s awareness of testicular cancer such as university campaigns and mass media. From a practical standpoint, clinicians must be encouraged to educate young men about BTD. This could be attained through tailoring creative educational interventions that are sensitive to the needs of individuals who are at risk for health disparities.

Exploring awareness and help-seeking intentions for testicular symptoms among heterosexual, gay, and bisexual men in Ireland: A qualitative descriptive study

BACKGROUND The incidence of malignant and benign testicular disorders among young men is on the rise. Evidence from three reviews suggest that mens knowledge of these disorders is lacking and their help-seeking intention for testicular symptoms is suboptimal. Qualitative studies have addressed mens awareness of testicular cancer, with none exploring their awareness of non-malignant diseases such as epididymitis, testicular torsion, and varicocele and none including sexual minorities. OBJECTIVE To explore, in-depth, heterosexual, gay, and bisexual mens awareness of testicular disorders and their help-seeking intentions for testicular symptoms in the Irish context. DESIGN This study used a qualitative descriptive approach. Data were collected via face-to-face individual interviews and focus groups. SETTINGS Participation was sought from a number of community and youth organisations and one university in Southern Ireland. PARTICIPANTS Maximum variation and snowball sampling were used to recruit a heterogeneous sample. A total of 29 men partook in this study. Participants were men, aged between 18 and 50 years, and residents of the Republic of Ireland. METHODS All interviews were audio-recorded and transcribed verbatim. Reflective field notes were taken following each interview. A summary of the interview was shared with selected participants for member-check. Data were analysed and validated by three researchers. Inductive qualitative analysis of manifest content was used. Latent content was captured in the field notes. Data analysis yielded two key themes. RESULTS The themes that emerged from the interviews were: Awareness of testicular disorders and their screening, and help-seeking intentions for testicular symptoms. Although most participants heard of testicular cancer, most did not know the different aspects of this malignancy including its risk factors, symptoms, treatments, and screening. Several men had a number of misconceptions around testicular disorders which negatively impacted their intentions to seek prompt help. Intentions to delay help-seeking for testicular symptoms were often linked to a number of emotional factors including fear and embarrassment, and social normative factors such as machoism and stoicism. In this study, culture was perceived by some participants as a barrier to awareness and help-seeking. In contrast, many believed that young men, especially those who self-identify as gay, are becoming increasingly interested in their own health. CONCLUSION Findings suggest the need to educate young men about testicular disorders and symptoms. This could be achieved through conducting health promotion campaigns that appeal to younger men, drafting national mens health policies, and normalising open discussions about testicular health at a young age.

Feasibility and usability of a virtual reality intervention to enhance men’s awareness of testicular disorders (E-MAT)

Testicular cancer is the most common cancer among men younger than 50, and benign testicular disorders such as torsion and epididymitis can be life-threatening if left untreated. Men’s awareness of testicular disorders is lacking, and their intentions to see help for symptoms of testicular disease are low. This study aimed to describe the development, feasibility, and usability of a virtual reality (VR) intervention designed to enhance men’s awareness of testicular disorders (E-MAT). We designed E-MAT as a three-level VR experience and tested its feasibility and usability with 15 men recruited from a university. Following exposure to the intervention, participants filled a 43-item questionnaire. Participants agreed that the technology was comfortable to use, testicular disorders were well represented, the use of light humor was appropriate, and the scientific facts were easy to understand. Participants also agreed that the intervention was suited for men from different sociodemographic backgrounds and felt confident using VR. Overall, participants perceived the intervention as user-friendly, enjoyable, and aesthetically appealing. To the best of our knowledge, VR has not been used to promote men’s health in the past, let alone increasing their awareness and help seeking for testicular disorders. We recommend testing the effectiveness of E-MAT and making it available on public platforms that men can access at their own leisure. VR can be used in future interventions to educate men about various health topics.

Promoting men’s knowledge of cancer risk reduction: A systematic review of interventions

OBJECTIVE To critically appraise and discuss evidence from interventions designed to increase mens knowledge about cancer risk reduction. METHODS A systematic review was conducted. Six electronic databases were searched for interventions published between January 1st 2006 and May 30th 2016 in English. Studies were included if they used an experimental design, included adult males (≥18 years), and had a primary focus on the acquisition and utilisation of information on cancer risk reduction. The methodological quality of the included studies was appraised. RESULTS A total of 25 studies met the inclusion criteria, 23 of which involved prostate cancer risk reduction. Twenty-one studies reported knowledge gain among the men. Three studies found that knowledge gain was associated with health literacy. CONCLUSIONS Interventions aiming to improve mens knowledge about cancer risk reduction require a multimodal approach. Findings highlight the need to design and measure the impact of interventions for men on wider cancer risk reduction topics, while accounting for different socio-demographic and ethnic groups, literacy and health literacy levels. PRACTICE IMPLICATIONS More research is warranted into the development and evaluation of theoretically-driven multimodal community-based approaches to information dissemination for men taking into account their daily information spheres such as workplaces and community environs.

Promoting men’s awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions

Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men’s knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men’s awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.