In 2004, the United States Preventive Services Task Force (USPSTF) gave testicular cancer (TCa) screening a ‘D’ recommendation, discouraging the use of this preventive service. The USPSTF suggested that screening, inclusive of testicular self-examination (TSE) and clinician examination, does not reduce TCa mortality rates and that the high risk of false positives could serve as a detriment to patient quality of life. Others suggests that TCa screening is ineffective at detecting early-stage cases of TCa and readily highlights a lack of empirical evidence demonstrating said efficacy. These assertions, however, stand in stark contrast to the widely held support of TCa screening among practicing public health professionals, advocacy groups, and clinicians.
In this present study, a review was conducted of the methods and processes used by the USPSTF in their 2011 reaffirmation of the ‘D’ grade recommendation. The evidence base and commentary offered as to why TSE, as part of the overall recommendation for TCa screening, was given a ‘D’ grade were analyzed for logical reasoning and methodological rigor.
Considering the methodological flaws and the veritable lack of evidence needed to grant a conclusive recommendation, the question is raised if the current ‘D’ grade for TCa screening (i.e. discourage the use of said service) should be changed to an ‘I’ statement (i.e. the balance of benefits and harms is indeterminate). Therefore the purpose of this paper is to present the evidence of TCa screening in the context of efficacy and prevention in order for the field to reassess its relative value.
Rovito, M.J., Manjelievskaia, J., Leone, J.E., Lutz, M.J., & Nangia, A. (2016). From ‘D’ to ‘I’: A Critique of the Current United States Preventive Services Task Force Recommendation for Testicular Cancer Screening. Preventive Medicine Reports, 3, 361-366. doi: 10.1016/j.pmedr.2016.04.006
Virtual Commons Citation
Rovito, Michael J.; Manjelievskaia, Janna; Leone, James E.; Lutz, Michael J.; and Nangia, Ajay (2016). From 'D' to 'I': A Critique of the Current United States Preventive Services Task Force Recommendation for Testicular Cancer Screening. In Movement Arts, Health Promotion and Leisure Studies Faculty Publications. Paper 109.
Available at: http://vc.bridgew.edu/mahpls_fac/109
Author retains copyright under a Creative Commons Attribution License 4.0 International License.