To evaluate the effectiveness and cost-effectiveness of screening for testicular cancer in asymptomatic adolescents, amidst ongoing debate about its value.
Key Findings:
43 cases of testicular cancer were identified, with an incidence rate of 3.67 per 100,000 person-years based on the total cohort.
Screening sensitivity was 66.7% at 6 months and 40% at 12 months.
Each cancer detected required screening of 75,198 adolescents, including 176 ultrasound tests and 112 specialist consultations.
Most cancers were diagnosed at stage I, regardless of screening.
Interpretation:
The low sensitivity and high number needed to screen, along with frequent unnecessary evaluations, indicate that routine screening of asymptomatic adolescents is ineffective and may not be a prudent use of resources.
Limitations:
Study population may not fully represent all demographics due to exemptions from military service and potential biases in screening practices.
Findings may not be generalizable to populations outside Israel.
Conclusion:
The findings do not support routine testicular cancer screening in asymptomatic adolescents due to low effectiveness and high resource utilization, suggesting a need for reevaluation of current screening guidelines.
