Investigation of knowledge, attitude and behaviors of university students on testicular cancer: results from two different cities

Abstract

Objectives: Testicular tumors are the most common malign tumor in men aged 15-35 years. Early diagnosis and treatment is crucial in testicular cancer because if detected at an early stage, testicular cancer can be completely cured. Because of this reason increase in awareness and regular testicular self-examination (TSE) is recommended in the early diagnosis of testicular cancer. This study aimed to investigate the knowledge, attitude and behaviors of students about testicular cancer and testicular self-examination.

Methods: This descriptive and cross-sectional study was conducted in Health care vocational schools of 2 different universities between November 2018 and January 2019. Data were obtained by a self-applied questionnaire comprised of four sections.

Results: One hundred and six (37.7%) participants could not answer any question correctly. While 65.8% (n = 185) of the participants stated that they had heard of testicular cancer, the rate of those who heard about TSE was 17.8% (n = 50). Only 5.7% (n = 16) of the participants reported performing TSE. Binary logistic regression analysis was shown that the following factors increase men’s intention to perform TSE: Students’ academic unit [OR  =  4.36, 95% CI: 1.37-13.88], age [OR  =  0.2; 95% CI: 0.008-0.72], city [OR  = 0.64; 95% CI: 1.15-1.49], those who have heard of TC before [OR  =  0.71, 95% CI: 0.016-0.917], received information about TC [OR  =  0.001, 95% CI: 0.015-0.309], and those who have heard of TSE before [OR  =  0.01; 95% CI: 0.001-0.079].

Conclusions: One-third of the university students had never heard of testicular cancer, ‎and TSE was not sufficiently practiced. There is a lack of information on this issue. It was thought that organizing training programs on the subject would raise awareness and save lives by early diagnosis.

Keywords

• Testicular neoplasms
• testicular cancer
• cancer screening
• testiculer self-examination
• knowledge
• behaviours

References

1. 1. Stephenson AJ, Gilligan TD. Neoplasms of the testis. In: Mcdougal WS, ed. Campbell-Walsh Urology. Elsevier Saunders Publishing, 1600 John F. Kennedy, Philadelphia, USA; 2011. pp. 150-60.
2. 2. Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C. Cancer mortality in Europe, 1995- 1999, and an overview of trends since 1960. Int J Cancer 2004;10:155-69.
3. 3. EU.Guidelines on testicular cancer. Albers P (ed). European Association of Urology 2016. [cited: 2019 April 12]. Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-Testicular-Cancer-2016-1.pdf
4. 4. Koca O. Testiculer Cancer Update. Academy of Turkish Urology, Turkey. [cited: 2019 April 13]. Available from: http://www.uroturk.org.tr/urolojiData/Books/397/testis-kanseri-guncelleme.pdf
5. 5. Yalcınkaya U, Calisir UN, Filiz G, Erol O. [Testicular tumors: results of a 30-year archive screening]. Türk Patoloji Dergisi 2008;24:100-6. [Article in Turkish]
6. 6. Kuzgunbay B. [Epidemiology, etiology and risk factors of testicular tumors]. Turkiye Klinikleri J Urology-Special Topics. 2016;9:1-4. [Article in Turkish]
7. 7. Michos A, Xue F, Michels KB. Birth weight and the risk of testicular cancer: A meta-analysis. Int J Cancer. 2007;121:1123-31.
8. 8. Anafarta K. Basic Urology. 1st ed. Ankara: Güneş Publishing; 1998.

9. 9. Smith ZL, Wentz RP, Eggener SE. Testicular cancer: epidemiology, diagnosis and management. Med Clin North Am 2018;102:251-64.
10. 10. American Cancer Society. Cancer facts and figures 2017. [cited: 2019 Aug. 14]. Availebale from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html.
11. 11. Ozturk C, Fleer J, Hoekstra HJ, Hoekstra-Weebers JE. Delay in Diagnosis of testicular cancer. a need for awareness programs. Plos One 2015;10:e0141244.
12. 12. Gutema, H, Debela Y, Walle B, Reba K, Vondiye H. Testicular self examination among Bahir Dar University students: application of integrated behavioral model. BMC Cancer 2018;18: 1-8.
13. 13. Khadra A, Oakeshott P. Pilot Study of Testicular cancer awareness and testicular self- examination in men attending two South London General Practise. Fam Pract 2002;19: 294-6.
14. 14. Ercan N. Knowledge, attitudes, and behaviors of university students on testicular cancer and testicular self-exam. Master thesis, Institute of Health Sciences, Marmara University of Medical Science, Turkey, 2006.
15. 15. Wardle J, Steptoe A, Burckhardt R, Vogele C, Vila J, Zarczynski Z. Testicular self-examination: attitudes and practices among young men in Europe. Prev Med 1994;23:206-10.
16. 16. Yılmaz E, Koca Kutlu A, Çeçen D. [Knowledge, attitudes, and behaviors of the students of the vocational school of health services ‎related to testicular cancer and testicular self-examination]. Fırat Sağlık Hizmetleri Dergisi 2009;4:72-85. [Article in Turkish]
17. 17. Pour HA, Çam R. [Knowledge, attitudes, and behaviors of men about testicular self-examination and testicular cancer]. F.N. Hem Derg 2014;22:33-8. [Article in Turkish]
18. 18. Ugurlu Z, Akkuzu G, Karahan A, Beder A, Dogan N, Okdem S, et al. Testicular cancer awareness and testicular self-examination among university students. Asian Pac J Cancer Prev 2011;12:695-8.
19. 19. Altınel B, Avci IA. [Knowledge, beliefs, and practices of university students on testicular cancer and testicular self-examination]. TAF Prev Med Bull 2013;12:365-70. [Article in Turkish]
20. 20. Gutema H, Debela Y, Walle B, Reba K, Wondiye H. Testicular self-examination among Bahir Dar University students: application of integrated behavioral model. BMC Cancer. 2018;18:1-8.
21. 21. Kedzierewicz R, Chargari C, Le Mouléc S, Ferrandez NJ, Ceccaldi B, Houlgatte A, et al. Knowledge and screening of testicular cancer in the French armed forces: a prospective study. Mil Med 2011;176:1188-11.
22. 22. Ugboma HAA, Aburoma HLS. Public awareness of testicular cancer and testicular self-examination in academic environments: a lost opportunity. Clinics (Sao Paulo) 2011;66:1125-8.
23. 23. Ward KD, Weg MW Vander, Read MC, Sell MA, Beech BM. Testicular cancer awareness and self-examination among adolescent males in a community-based youth organization. Prev Med 2005;41:386-98.
24. 24. Ramim T, Mousavi SQ, Rosatmnia L, Bazyar A, Ghanbari V. Student knowledge of testicular cancer and self-examination in a Medical Sciences University in Iran. Basic Clin Cancer Res 2014;6:7-11.
25. 25. Nowicki GJ, Ślusarska B, Bartoszek A, Kocka K, Luczyk M, Szlachetka ZS, et al. The frequency of the self-examination of testicles among men in selected socio-demographic conditions. Med Sci Pulse 2017;11:10-5.
26. 26. Farrow JA. Male sexual health during adolescence and young adulthood: contemporary issues. J Men Health 2009;6:177-82.
27. 27. Ugwumba FO, Ekwueme OE, Okoh AD. Testicular cancer and testicular self-examination: knowledge, attitudes and practice in final year medical students in Nigeria. Asian Pac J Cancer Prev 2016;17:4999-5003.