title: Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria
abstract: The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up
  to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being
  witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality
  high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future
  first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular
  cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect
  of an intervention in the form of a single PowerPoint® lecture, lasting 40 minutes with image content on testicular
  cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered
  structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response
  rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of
  the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor
  awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor
  level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the
  study group..Respondents had surprisingly weak/poor responses to the question “How important to men’s health is
  regular testicular self-examination?” Answers to the questions “Do you think it is worthwhile to examine your testis
  regularly?” and “Would you be interested in more information on testicular cancer and testicular self-examination?”
  were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status
  were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology
  of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor
  attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational
  intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting
  adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other
  training institutions for health care personnel.
authors.affiliation: Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria. Email: fredugwumba@gmail.com
authors.forename: Fred O
authors.initials: FO
authors.lastname: Ugwumba
authors.forename: Osa Eloka C
authors.initials: OE
authors.lastname: Ekwueme
authors.forename: Agharighom D
authors.initials: AD
authors.lastname: Okoh
keywords: Testicular cancer; testicular self-examination; knowledge; attitudes; practice; medical students