title: Has increasing public health awareness influenced the size of testicular tumours among adult populations over the last 40 years?
abstract: Testicular cancer is the commonest malignancy in young men. Improvements in survival rates have led to campaigns to raise awareness in at-risk men. We assessed the changing size of testicular tumours given the public health initiatives promoting testicular self-examination (TSE).
  
  
  
  Retrospective analysis of men (≥16 years) undergoing orchidectomy for testicular cancer at our institution over two time periods (1975-85 and 2007-12) were identified using our cancer registry. Histopathology reports were used to record testicular tumour size as the maximum measured dimension. Significance was indicated by P < 0.05.
  
  
  
  Of 305 orchidectomies performed, 215 had histopathology reports available. Median age was 34 years (16-75 years). Mean tumour size was 7.2 cm in 1975-85 and 4.1 cm in 2007-12 showing a significant reduction (P = 0.02). Significant reduction was seen in all age groups except >60 years. Furthermore there was a significant increase in proportion of men presenting in the youngest age group (16-29 years) in the 2007-12 cohort (43 versus 29%, P = 0.02).
  
  
  
  The trend in reduction of tumour size at presentation and increased proportion of younger men presenting with testicular cancer supports an increased awareness. Promotion of TSE and public education should remain important initiatives given the increasing incidence of testicular cancer. Awareness still needs addressing in older men.
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK.
authors.forename: Luke A
authors.initials: LA
authors.lastname: McGuinness
authors.affiliation: Department of Urology, Royal Liverpool and Broadgreen Hospitals, Kent Lodge, Broadgreen Hospital, Liverpool, UK.
authors.forename: Samer
authors.initials: S
authors.lastname: Obeidat
authors.affiliation: Department of Urology, Royal Liverpool and Broadgreen Hospitals, Kent Lodge, Broadgreen Hospital, Liverpool, UK.
authors.forename: Bethan
authors.initials: B
authors.lastname: Hickerton
authors.affiliation: Department of Urology, Royal Liverpool and Broadgreen Hospitals, Kent Lodge, Broadgreen Hospital, Liverpool, UK.
authors.forename: Ronan
authors.initials: R
authors.lastname: Long
mesh_terms: D000293:Adolescent; D000328:Adult; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012042:Registries; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology*; D006113:United Kingdom; D055815:Young Adult
keywords: cancer; genitourinary diseases; health promotion