Genç erişkin erkeklerde kendi kendine testis muayenesi yapma sıklığının araştırılması

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Introduction
Testicular cancer is one of the health problems, frequency of which continuously increases. Testicular
tumors are the second most frequent malignancy after leukemia in males at the age group of 20-35 (1).
The incidence of testicular cancer shows variations
between countries, races and socio-economic classes.
The rate is 6.7% and 0.8 in Scandinavian countries
and Japan, respectively. In the USA 2-3 new cases are
reported per 100.000 males per year (2). The risk of
a development of testicular cancer in white males in
the USA during the whole life is at a level of 0.2%.
The incidence in people of higher socio-economic
classes is half of the lower socio-economic classes (2).
Although the reason for testicular cancer is not
known exactly, there is knowledge regarding that
both congenital as well as some acquired factors
are responsible in tumor development. The strongest relationship is with an “undescended testis”.
Approximately 7-10% of testicular cancers develop
with cryptorchidism history. The cryptorchidism
prevalence is 9.2-30.0% in premature births and 3.5-
5.8% in mature births. Cryptorchidism frequency is
0.8-1.0% during the first age and remains unchanged
with a ratio of 0.7% until puberty (3). Five to 10% of
testicular tumors occur on the opposite side, in the
normal descended testis. The highest relative malignancy risk (1 of 20) is met in intra-abdominal testis. Placement of the cryptorchid testis into the scrotum (orchidopexy) reduces the malignancy potential of the cryptorchid testis (2). The frequency of testicular cancer cases met on the right side is 52.3%, on
the left side 47.7%, and the frequency of being bilateral is 2-3% (4).
In general the patients consult the physician due to
a painless single side bulge and mass in the scrotum.
The growth of the testis in general develops slowly
and a feeling of testicular pain is experienced. The
common accepted opinion is that until the opposite
* Department of Plan and Programming, Commandership of Health, Turkish
Military Forces
** Department of Public Health, Gulhane Military Medical Faculty
*** Department of Urology, Gulhane Military Medical Faculty
This study was presented at the 12th National Congress of Public Health
(Ankara, October 21-25, 2008)
Reprint request: Dr. Ercan Göçgeldi, Department of Plan and Programming,
Commandership of Health, Turkish Military Forces, Bakanlıklar, Ankara, Turkey
E-mail: drnkocak@gmail.com
Date submitted: July 15, 2010 • Date accepted: November 01, 201018 • March 2011 • Gulhane Med J Göçgeldi et al.
is approved, a determined asperity in the testis needs
to be deemed as a malign tumor (3). Other symptoms
are gynecomasty, pigmentation on the scrotum, and
pain in the abdomen and the groin. Scrotal pain develops at the late period of the tumor as a result of tunica albuginea or epididymis invasion (4).
The time between the first discovery of the lesion
in the testis and start of the definite treatment (orchidectomy) is 3-6 months in average. The time of the
delay shows a correlation with the incidence of the
metastasis. Approximately 10% of the patients are
asymptomatic and can be detected upon trauma or
by the sexual partner of the patient (3).
Testis tumor often mimics epididymitis and epididymorchidis. Ten per cent of testis tumors mimics
orchiepididymitis. Their diagnosis can easily be made
with ultrasound and anamnesis. Other diseases to be
considered during the diagnosis are spermatocele,
traumatic hematocele, granulomatous orchitis, varicocele and epidermoid cysts (3).
Testicular cancer can be treated completely when
they are detected in early stages. The chance for a
5-year life is 99.9% with early diagnosis (5). Among
the basic diagnostic methods, ultrasound, transillumination and computed tomography can be mentioned (1,3). Individuals’ awareness and their performing a testicular self examination (TSE) by themselves is important regarding an early diagnosis (3).
Routine testicular self examination (R-TSE) is an
examination performed by the person himself at least once a month and regularly, which is made by
using both hands, while holding the testis with one
hand and examining the testis on masses during bathing or after bathing in front of a mirror (1,6). Along
with the advantages that R-TSE is easy to learn and
to apply, safe, non-invasive, economic, and does not
need any special tools and devices, take time. When
it is performed regularly each month, it provides that
changes are detected early because the testis structure
is known.
There are some studies examining testicular cancer
and TSE performance frequencies. In these studies,
TSE performance frequency varies according to the
attributes of the group with which the study is realized. The frequencies of hearing about testicular cancer and TSE and performance of TSE in these studies
are summarized in Table I.
In the study performed by Ercan et. al. among 867
male university students between the ages of 18-30
years, it is determined that 8.9% of the participants
have heard about TSE, and 5.1% perform TSE (6). In
the study performed by Lechner et. al. among 274 students between the ages of 15-19 years, it is determined that 3.0% of the participants have heard about
TSE and 2.0% performed TSE (5). The TSE performance
frequency of the participants of the study realized by
Khadra et. al. among 202 persons of the ages of 18-50
years who consulted a polyclinic providing first stage
health services is determined as 22.0% (7). In the study
performed by Moore et. al. among 203 people who are
university students or graduates between the ages of
20-45 years, it is determined that 32.0% of the participants have heard about TSE and 22.0% performed TSE
(8). In the study by Rudberg et. al. performed among
university students in Sweden, it is determined that
many of the students have not heard anything about
TSE (9). In the study of Tichler et. al. among 717 soldiers and 200 military physicians in the Israeli army,
2.0% of the soldiers and 73% of the physicians have
stated that they have performed TSE (10). In the study
of Vaz et. al. among 1364 adolescent males, 28.0%
of the participants stated that they had heard about
testicular cancer (11). In this study of Wardle et. al.
among 7304 young male adults, it is stated that 13.0%
of the participants have performed TSE (12). In the
study by Neef et. al. among 404 male college students,
it is stated that 42.0% of the participants heard about
TSE, 22% performed TSE before (13). In the study by
Cummings et. al. among 266 university students and
male graduates, it is determined that 16.0% of the participants have heard about TSE (14). In the study of
Christine et. al. among 191 young adult males between the ages of 18-35 years, it is stated that 36.0% of the
participants have performed TSE (15).
It is rather important that the male become more
aware on testicular cancer, of which the frequency of
incurrence has raised during the last years, they learn
and apply TSE as an early diagnostic method. The aim
of this study was to determine the testicular self examination performance frequency in young adult males.
Material and Methods
The universe of this study, planned in cross section type, was constituted by 5033 persons, who joined the Etimesgut Armoured Units Education
Center Commandership in the recruitment period in
November 2007. There is no sample selection made
for the study, it is targeted to reach the whole universe in a term of one week upon the start of the arrival
of the soldiers to the unit. As some soldiers joined the
unit except for working hours and that some rejected
to participate in the study, not the whole of the universe could be reached, the study was performed with
3645 (72.4%) persons.
The data were collected by the researchers using the
question form, developed by the researchers after a li-Volume 53 • Issue 1 Testicular self examination • 19
terature hatch. On the question form, there are 7 questions regarding their socio-demographic attributes,
3 questions regarding the stories of the participants
regarding cancer and testicular cancer, 10 questions
regarding testicular self examination in order to determine their behavior and 15 questions regarding
testicular cancer, symptoms and TSE were included
into the knowledge test. The pre-test of the question
form, prepared by the researchers was made with 20
soldiers of the Gulhane Military Medical Academy.
Support Troops Command, failures regarding the
application and easiness to understand and observed
failures regarding data entrance are amended. It was
approved by the ethic commission.
Groups of 20 persons of the soldiers who joined
the Etimesgut Armoured Units Education Center
Commandership in November 2007 were interviewed, the study and its aim were explained, if they
should want to participate (those who orally accepted to) necessary information regarding some definitions in the inquiry (testis, undescended testis, testicular self examination) is provided orally such that
the participants can understand these and provided
that they answer the questions under observation.
The recruitment age in Turkey is 20 and those, who
are not hindered join the Armed Forces in general at
the age of 21 years. But only at a little part the recruitment age is later due to several reasons. Thus, in general male perform their military services at the age
of 20-21. For that, the ages are grouped as 20-21, 22-
24, 25 years and above. The occupational information of the participants is obtained as open end and
afterwards a grouping regarding being or not-being
related to healthcare is performed. The demographic
distribution of the participants is grouped by the regionalization system of five of the Turkish Statistic
Institute by respecting their provinces of birth.
The data were analyzed by using the SPSS 10.0 package statistic software. The descriptive statistics were
given as frequencies and percent. The TSE performance frequencies and completeness of some sociodemographic with descriptive attributes, the completeness of giving correct answers to each question
of the knowledge test with the TSE performance freTable I. Brief findings of studies regarding the performance of a testicular self examination
Researchers Research type Age group Group attribute
(n)
Hearing of
testicular
cancer
Hearing
of TSE
At least one
performance
of TSE in life
At least once
a month
performance
of TSE
Country
Ercan et. al. (6) Cross sectional 18-30 University students
(867)
42.9% 8.9% 5.1% Turkey
Lechner et. al. (5) Descriptive 15-19 High-school students
(274)
26.0% 3.0% 2.0% Holland
Khadra et. al. (7) Descriptive 18-50 People consulting
polyclinic providing
a first stage health
services
(202)
91.0% 28% 22% England
Moore et. al. (8) Descriptive 20-45 University students and
graduates (203)
90.6% 32.0% 22.0% 5.06% England
Rudberg et. al. (9) Cross sectional 15-21 High-school students
(727)
11.3% 5.6% 11.5% 1.2% Sweden
Tichler et. al. (10) Descriptive Male soldiers (717) 2% Israel
Military physicians (200) 73%
Vaz et. al. (11) Descriptive Adolescent (1364) 28% USA
Wardle et. al. (12) Cross sectional Young adult
male
16486 students 13% England
Neef et. al. (13) Descriptive College students
(404)
42% 22% 8% USA
Cummings et. al.
(14)
Descriptive University students and
graduates
(266)
16% USA
Christine et. al. (15) Descriptive 18-35 People living in industry
complex
(191)
36% USA20 • March 2011 • Gulhane Med J Göçgeldi et al.
quency, of which it was thought that they may have
an effect on this, was compared with the chi-square,
and the comparison of the average of the participants
giving correct answers at the knowledge test according to their socio-demographic and descriptive attributes was compared with the Kruskal-Wallis and the
Mann-Whitney U test. A p value of <0.05 was accepted statistically significant.
Results
The age of the participants was between 20 and 44
years. The average age was 20.6±1.4 and 85.6% was
in the age group of 20–21 years. When the location
of birth was respected, 35.8% were born in province
centers, 24.6% in districts, 93.4% of the participants
were single and 67.2% were high-school graduates,
61.4% mentioned that they were actually smokers
and 31.4% mentioned that they never smoked, 0.9%
of the participants were occupied in health related
professions. Some of the socio-demographic attributes of the young adult males, participated in the
study, are given in Table II.
23.3% of the participants mentioned that they had
heard about testicular cancer, 14.1% that there was a
cancer history in the family or among their relatives
(3.2% within the family, 10.9% among other relatives). And 0.1% had testicular cancer among their
relatives (Table III).
Table II. Some sociodemographic attributes of the participants
n %
Age 20–21 3120 85.6
22–24 462 12.7
25 and above 63 1.7
Marital
status
Single 3405 93.4
Married 233 6.4
Widowed-divorced 7 0.2
Place of
birth
West 1045 28.7
East 840 23.0
Central 686 18.8
North 601 16.5
South 473 13.0
Settlement
type of birth
State 1304 35.8
District 898 24.6
Town 610 16.7
Village 833 22.9
Education
level
Below primary school (4 years and less) 58 1.6
Primary school (5 years) 149 4.1
Secondary school (8 years) 838 23.0
High school (11 years) 2450 67.2
University-faculty graduate
(13 years and above)
150 4.1
Occupation Health related profession 32 0.9
Other 3613 99.1
Smoking
habit
Never smoked 1146 31.4
Actually smoking 2237 61.4
Previously smoking, quit 262 7.2
Table III. Distribution of the participants regarding hearing
about testicular cancer and existence of cancer story among
relatives
n %
Hearing about testicular
cancer
Yes 849 23.3
No 2796 76.7
Any cancer case in the
family (1st degree relatives)
Yes 118 3.2
No 3527 96.8
Any cancer history among
other relatives
Yes 397 10.9
No 3248 89.1
Cancer type among all
relatives
Testicular cancer 3 0.1
Other cancer 503 13.8
No cancer 3139 86.1
Table IV. Hearing about and performance of TSE in participants
n %
Hearing about TSE Yes 249 6.8
No 3396 93.2
Performance of TSE even at
least once in life
Yes 170 4.7
No 3475 95.3
Table V. Reasons for non-performance of TSE in participants
n %
Not knowing how to perform a TSE 1878 54.0
Not knowing why to perform a TSE 690 19.9
Deeming not necessary 907 26.1
Total 3475 100.0
6.8% of the participants mentioned that they have
heard about TSE, 4.7% that they have performed TSE
at least once during their life (Table IV).
54% of those participants, who even did not perform TSE once in their life, mentioned that they did
not know how to make a TSE, 19.9% did not know
why it was necessary to be performed, and 26.1%
mentioned that they did not deem it to be necessary
(Table V).
The attributes of performing TSE in 170 participants,
who mentioned that they have performed TSE at least
once during their life, is given in Table VI. It was determined that 51.8% of these participants performed TSE
in right frequency (at least once a month), and 48.8%
at the right time (in bath and/or direct after bathing).
It is determined that the ratio of the 41.2% of those,
who mentioned performing TSE at the right time and Volume 53 • Issue 1 Testicular self examination • 21
Table VI. Attributes of participants who performed TSE at least once in life (n=170)
n %
TSE performance frequency Less than once a year 43 25.3
Approximately once a year 17 10.0
Approximately once every six months 11 6.5
Approximately once every three months 11 6.5
At least once a month* 88 51.8
TSE performance time Before sleeping 19 11.2
After waking up in the morning 15 8.8
Directly before taking a bath 41 24.1
In the bath* 76 44.7
Directly after taking a bath* 7 4.1
At any time 12 7.1
Performance of testis examination at right
time and frequency
Yes 70 41.2
Others 100 58.8
Source of information regarding TSE
&
Learned myself 59 34.7
Learned from friends 38 22.4
Learned from health personnel 33 19.4
Learned from TV/newspaper 20 11.8
Learned from teacher 3 1.8
Learned from the internet 2 1.2
Learned from father 2 1.2
Learned from girlfriend 1 0.6
Learned from brother 1 0.6
How competent do you feel yourself on TSE Know very well 18 10.6
Know well 77 44.3
Not sure 62 36.5
Don’t know 5 2.9
*Choices for performing testis examination at right time and frequency
&
More than one choice is selected
Table VII. Behavior of participants at a suspicion on testicular cancer, the importance of TSE for early diagnosis of testicular cancer and
whether they want to learn TSE or not, if they want to learn frequency of how they request it
n %
What they will do when they detect a mass in the testis* Immediately consult a physician 2916 80.0
Talk to the family 905 24.8
Ask friends 739 20.3
Use medicine 140 3.8
Wait until it disappears 246 6.7
Look in the internet 6 0.2
Research 9 0.2
I don’t know 16 0.4
Importance of TSE for early diagnosis of testicular cancer No idea/don’t know 2289 62.8
No, no importance 66 1.8
Very little importance 65 1.8
Rather important 496 13.6
Definitely very important 729 20.0
Would you like to learn how to perform TSE?* I don’t want to perform 651 17.9
I want it to be taught by health personnel 1553 42.6
I want it to be explained in form of conference 1302 35.7
I want it to be shown as a film 1119 30.7
I want to learn by the provision of brochures 584 16.0
I want to learn it from TV 259 7.1
I want to learn it from newspaper/magazine 191 5.2
*More than one choice selected22 • March 2011 • Gulhane Med J Göçgeldi et al.
in right frequency, was 1.9% among all participants.
34.7% of those, who performed TSE at least once,
mentioned that they learned to perform TSE by themselves, 22.4% from their friends, 19.4% from health
personnel, 11.8% from printed and visual media, and
54.9% mentioned that they deemed themselves as capable regarding performing TSE.
In case of detecting a mass in their testis, 80.0%
of the participants mentioned that would consult a
physician, 24.8% that they would talk to their family,
and 20.3% that they would ask their friends. Whilst
62.8% mentioned that they would not know about
the importance of TSE for the early diagnosis of the
cancer, 33.6% mentioned that they think that it was
important. 42.6% of the participants wanted TSE to
be taught by health personnel, 35.7% by explaining
in form of a conference, 30.7% by showing in form of
a film and 16.0% by providing brochures (Table VII).
The distribution of participants according to performance of TSE at least once in their lives according to
the socioeconomic and their descriptive attributes is
given in Table VIII. That, even only once in their life,
the TSE performance ratio in the age group of 25 and
above, at employees of profession branches related
to health and those who heard about testicular cancer and TSE is deemed to be statistically significant.
Beside this, when locations of birth is respected, it
is seen that there are differences at statistically significant level between regions and that it is highest
in northern regions (p<0.05). Although it is observed
that there is an increase of performing TSE the more
the education level increases, this is not deemed statistically significant. Along with this, when the mariTable VIII. Comparison of sociodemographic and some descriptive attributes with performance of TSE at least once in life of participants
Attribute
Performance of TSE at least once in life
Yes No p*
n % n %
Age group 20–21 124 4.6 2574 95.4 0.016
22–24 35 4.2 806 95.8
25 and above 11 10.4 95 89.6
Marital status Married 7 3.0 226 97.0 0.386
Not married 163 4.8 3242 95.2
Education level Below primary school 1 1.7 57 98.3 0.281
Primary school 6 4.0 143 96.0
Secondary school 38 4.5 800 95.5
High school 113 4.6 2337 95.4
University-faculty 12 8.0 138 92.0
Occupation Health related 6 16.2 31 83.8 0.007
Other 164 4.5 3444 95.5
Origin South 17 3.6 456 96.4 0.028
West 43 4.1 1001 95.9
East 35 4.2 806 95.8
Central 32 4.7 655 95.3
North 43 7.2 557 92.8
Settlement unit of birth Village 33 4.0 800 96.0 0.509
Town 25 4.1 585 95.9
District 47 5.2 851 94.8
Province center 65 5.0 1239 95.0
Smoking habit Never smoked 58 5.1 1088 94.9 0.312
Smoking 96 4.3 2141 95.7
Smoked and quit 16 6.1 246 93.9
Hearing about testicular cancer Yes 65 7.7 784 92.3 <0.001
No 105 3.8 2691 96.2
Hearing about TSE Yes 79 31.7 170 68.3 <0.001
No 91 2.7 3305 97.3
Cancer history among relatives Existent 26 5.1 480 95.9 0.570
Not existent 144 4.6 2995 95.4
Total 170 4.7 3475 95.3
* Fisher’s Exact chi-square testVolume 53 • Issue 1 Testicular self examination • 23
tal status, birth-living unit, smoking habit, cancer
history among relatives are respected, the difference
of TSE performance frequency is not deemed to be
statistically significant (p>0.05).
As a result of the knowledge test applied regarding
TSE and testicular cancer and its indicators, the sociodemographic and descriptive attributes of the participants and their ratio of giving right answer are given in Table IX. It is determined that the more the
number of correctly answered questions increases the
more the age and education level increases. This increase is deemed to be statistically significant in those
who had heard about TSE, performed TSE, heard about testicular cancer and non-smokers.
The information source of those participants, who
performed TSE, even only once in their life, and the
Table IX. Comparison of some attributes of the participants with the average of correct answers on the questions of the knowledge tests
applied regarding performance of TSE and testicular cancer and its symptoms
n Average SS p value
Age group 20–21 years old 2698 2.3 2.8 <0.001
&
22–24 years old 841 2.5 2.8
25 and older 106 3.4 3.3
Marital status Married and widowed 240 2.3 3.1 0.166*
Single 3405 2.4 2.8
Educational status Below primary school 58 1.7 2.7 <0.001
&
Primary school 149 2.4 3.1
Secondary school 838 2.1 2.8
High school 2450 2.4 2.8
University-faculty 150 3.0 3.1
Place of birth
(Demographical region)
South 473 2.3 2.8 0.323
&
East 841 2.3 2.9
Central 687 2.4 2.9
North 600 2.4 2.7
West 1044 2.4 2.9
Settlement unit of birth Village 833 2.4 2.9 0.925
&
Town 610 2.4 2.9
District 898 2.3 2.8
Province 1304 2.4 2.8
Occupation Health related 37 3.3 3.2 0.053*
Other 3608 2.5 2.8
Hearing about TSE Yes 249 3.9 3.3 <0.001*
No 3396 2.3 2.8
Performance of TSE Yes 170 4.4 3.7 <0.001*
Other 3475 2.3 2.8
Cancer story among 1st grade relatives Yes 506 2.4 2.7 0.553*
No 3139 2.4 2.8
Hearing about testicular cancer Yes 849 3.1 3.1 <0.001*
No 2796 2.1 2.7
Smoking habit No 1146 2.5 3.0 0.024
&
Yes 2237 2.3 2.8
Used to smoke 262 2.6 2.8
&
Kruskal-Wallis H test
*Mann-Whitney U test
Table X. Comparison of information sources and correct answer
average of the knowledge tests of TSE performing participants
n mean SS p*
Information
source for
TSE (n=170)
Himself Yes 59 3.8 3.6 0.140
No 111 4.7 3.6
Health personnel Yes 33 5.6 4.1 0.064
No 137 4.1 3.5
Friends Yes 42 4.0 3.0 0.527
No 128 4.5 3.8
TV/Newspaper Yes 20 5.6 3.6 0.088
No 150 4.2 3.6
Teacher/Lessons Yes 3 3.3 2.9 0.675
No 167 4.4 3.7
Internet Yes 2 7.0 2.8 0.314
No 168 4.3 3.7
*Mann-Whitney U24 • March 2011 • Gulhane Med J Göçgeldi et al.
averages of correct answers they gave to questions
regarding TSE, testicular cancer and its indicators in
the knowledge test are examined and the average of
correct answers of those, who mentioned health personnel, TV/newspaper, internet as the information
source is determined as being a little bit higher, but
this difference is not statistically significant (p>0.05)
(Table X). Beside this, regarding the status of giving
correct answers to all questions in the knowledge
test, the frequency of performing TSE among those,
who gave correct answers, is determined that their
TSE performance frequency is higher.
Discussion
In this study performed in order to determine the
performance frequency of TSE among young adults
by themselves and the effective factors, it was determined that 6.8% of the participants heard about TSE,
that 4.7% performed TSE even if at least once in their
life, that 2.4% performed TSE at least once a month
and that 2.3% performed it in the bath and/or directly after bathing.
Although the frequency of hearing about and performing TSE in our study shows similarities to some
studies given in Table 1, they are determined to be
much lower than of many other studies. Similarly it
is determined that the frequency of awareness of testicular cancer is low.
The great differences of the results between the
studies of Ercan et. al. on university students and
the one of Moore et. al. on university students and
graduates in London results in the thought that the
frequency for performing TSE is rather related to the
awareness of the society than to the education level.
In our study, even if an increase is to be seen at the
performance of TSE with the increase of the education level, this is not deemed to be statistically significant. These findings support the thought that the
awareness of the society is more efficient.
In our study, the frequency of those, who perform
TSE at least once a month (2.4%) is found to be less
compared to many other studies (Khadra et. al.; 22%
(7), Moore et. al.; 22% (8), Wardle et. al.; 13% (12),
Neef et. al.; 22% (13), Christine et. al.; 36% (15)). The
reason for that the results of the studies of Moore and
Khadra may be that the ages of the participants were
high and that these were performed among persons,
who consulted the polyclinic (7,8).
In our study, those who think that TSE is important
for the early diagnosis of testicular cancer constituted 35.4% of the participants. Rodrigues et. al., who
performed a similar study among university students,
determined that the participants are not aware about the importance of TSE for an early testicular cancer diagnosis (16). In our study, the participants answered the questions regarding the symptoms of testicular cancer by 17.6% like knob in the testis, 22.3%
pain in the groin, 13.6% heaviness feeling of the testis choices correctly. Similar results are achieved in other studies in the literature; in the study of Ercan et.
al. among university students 22.3% mentioned that
a swelling of the testis, 29.9% that a pain in the groin or a feeling of heaviness are the symptoms of testicular cancer (6). Beside this, in the study of Rodrigues
et. al. performed among university students, it is determined that only 2.4%, and that of Klein et. al.
among male of the ages 15-20 years only 1.5% of the
participants know the symptoms of testicular cancer
(16,17).
In our study, the correct answering of all questions
of the applied knowledge test regarding TSE, testicular cancer and symptoms and the frequency of performing TSE is examined and it is determined that
the TSE performance frequency is higher among those who answered the questions correctly. This finding
led to the thought that the information of the society
will contribute to the increase of the TSE performance frequency.
One of the reasons for that at the study performed
in London by Khadra et. al. may be that the countrywide “Everyman” campaign in England regarding
testicular cancer and TSE was positively perceived by
the society (7).
In our study it is determined that the frequency of
hearing about TSE and performing TSE among the reached population is very low, but that this is higher
among those who heard of testicular cancer. Beside
this, it is determined that nearly four of five of the
participants want to learn TSE.
By the organization of well planned educations,
supported by various educational materials, in order
to increase the awareness on testicular cancer and
the TSE performance frequency, country-wide applied campaigns, the awareness and knowledge of the
society regarding testicular cancer and TSE may be
increased. Therefore, the attention may be directed to
a health problem which people are not enough aware
of and which may be prevented by early diagnosis. As
a result of this, the early diagnosis of testicular cancer
may increase the treatment possibility.