Cancer Screening Guidelines for Testicular Cancer Survivors
Patients with a history of testicular cancer should follow standard age-appropriate cancer screening guidelines recommended for the general population, with no additional cancer screening protocols required beyond routine health maintenance. 1
Key Guideline Recommendation
The 2019 American Urological Association explicitly states that additional cancer screening beyond what is recommended for the general population is not recommended for testis cancer survivors. 1 This applies regardless of whether the patient received radiation therapy, chemotherapy, or both treatments.
Important Survivorship Considerations
While additional cancer screening is not indicated, testicular cancer survivors do require specific monitoring for treatment-related complications:
Cardiovascular Disease Risk
- Patients treated with radiation therapy and/or chemotherapy face elevated cardiovascular disease risk and should establish regular primary care to monitor modifiable risk factors including diet, exercise, smoking cessation, lipid levels, blood pressure, and glucose control. 1
- This cardiovascular monitoring is critical for morbidity and mortality reduction in this population. 1
Secondary Malignancy Awareness
- Survivors treated with radiation or chemotherapy should be counseled about their elevated risk of secondary malignancies and maintain appropriate health care maintenance with their primary care physician. 1
- However, this awareness does not translate into additional screening protocols beyond standard age-appropriate guidelines. 1
Hypogonadism Monitoring
- All testicular cancer survivors should be monitored for signs and symptoms of hypogonadism. 1
- If hypogonadism symptoms are present, measure serum AM testosterone and luteinizing hormone levels. 1
Standard Age-Appropriate Screening
Your patient should receive the same cancer screening as any male of his age group, which typically includes:
- Colorectal cancer screening beginning at age 45-50 (per standard guidelines for average-risk individuals)
- Skin cancer surveillance with annual total body skin examinations if age >40 years, or every 3 years if age 20-40 years 1
- Lung cancer screening if he meets age and smoking history criteria (age 50-80 with 20 pack-year history)
- Other age-appropriate screenings per USPSTF recommendations
Common Pitfall to Avoid
Do not order additional imaging, tumor markers, or specialized cancer screening protocols based solely on testicular cancer history. The excellent cure rates (>90% overall survival) 2, 3 and lack of evidence supporting enhanced surveillance make this approach both unnecessary and potentially harmful through false-positive results and associated anxiety. 2