Testicular cancer (TC) is a rare form of cancer [1]. It is estimated that about 8,000–10,000 new cases are diagnosed each year globally. TC has a very high cure rate of about 95%; it is estimated that only 400 deaths will be recorded from TC yearly in the USA [2, 3]. Despite its rarity, it is the most common cancer affecting men between the ages of 15 – 49 years; and it is the second most common cancer affecting men aged 15–19 years globally [4]. The mean age for a diagnosis of TC is 33 years [5]. However, TC can occur at any age. Over many decades, the incidence rate of testicular cancer in several countries has been increasing [3]. The highest incidence rates were recorded in Western and Northern European countries and the lowest is recorded in Africa [6]. Retrospective studies have shown that the prevalence rate of TC is low in Nigeria [7, 8]. A prospective study of 24 patients showed that five died, five survived beyond five years post-treatment, and the rest were lost to follow up and did not complete treatment [9]. Of these patients, 62.9% reported when the disease was at Stage 3 or 4. This study exemplifies the challenges associated with TC management in Nigeria [9]. Despite the low prevalence rate, TC management is still hindered by late presentations and limited resources for cancer prevention, diagnosis, and treatment [9].

Although TC is a highly curable disease, successful treatment is dependent on early diagnosis of the condition [2]. If treatment is not commenced immediately, it spreads rapidly to other body parts. Hence, it is imperative that the disease is diagnosed promptly. Some types of TC are asymptomatic until they reach an advanced stage; however, most TC manifest with the presence of a small lump which can be easily detected through testicular self-examination (TSE) before the disease spreads [10]. TSE is the inspection of the appearance and texture of testicles to observe their condition and help detect when abnormal changes occur [11]. While some experts dispute the relevance of TSE, others believe it can be helpful in the early detection of TC [10]. It is often recommended that men at risk of TC perform TSE monthly, but some doctors recommend that TSE be performed monthly after puberty by all men [10].

The TSE should be performed after a hot bath/shower because the testes are more relaxed; hence, the testicles can be easily palpated. During TSE, the man should look out for the following: the presence of smooth or rounded lumps and changes in size, shape or consistency of the testes [10]. TSE can also help in the early detection of testicular torsion and varicocele [12]. Hence, it is imperative that men perform TSE regularly to aid early detection of TC and other abnormalities.

Some studies have explored the awareness of TC and practice of TSE among various groups of teenage and adult men. Some studies in Nigeria found that most had good knowledge about TSE but never practised it [13, 14]. Other studies reported a poor awareness about TC and TSE and low practice of TSE [15,16,17]. Another study reported a deficit in men’s awareness towards TSE, and they reported that less than one in five men regularly examine their testicles [18]. Respondents’ reasons for not performing TSE include feeling embarrassed by TSE, lacking the knowledge and feeling incompetent, and not caring about TSE [13, 15, 16]. Studies focussing on medical and nursing students have shown a high level of awareness, low knowledge of both TC and TSE, and poor practice of TSE [16]. It appears that many men do not understand the risks of TC and the importance of TSE [19]. This shows that possessing knowledge does not always translate to a regular practice of TSE. These studies have recommended the use of various educational strategies to increase awareness about TC and the importance of TSE. Similar strategies have successfully improved the awareness of breast and cervical cancer, the practice of breast self-examination and the uptake of cervical cancer screening strategies [20,21,22].

This study examined the awareness and practice of TSE by male undergraduate students at a College of Health Sciences. This is important in health promotion and disease prevention particularly for their prospective patients when they commence their practice as health practitioners. As future healthcare professionals, they play an essential role in educating patients and the society on relevant preventive strategies against diseases such as TC. However, if they are not knowledgeable about TSE then they will be ill-equipped to provide this education. This study will provide lecturers and heads of nursing, medical and allied health schools the opportunity to identify the deficiencies in the educational system regarding TSE to establish/update policies and courses to ensure TSE is included in the training of these future healthcare professionals. Though this study was conducted in Nigeria, its findings can influence medical and nursing education globally by drawing the attention of lecturers and faculty members to the importance of including TSE in the training of healthcare professionals. Also, this study will provide baseline information that will guide the development of interventions and serve as reference material for men, teachers, and researchers. The objectives of this study were to determine the awareness and practice of TSE among male undergraduate students in a Nigerian university, and to explore any association between awareness and practice of TSE.

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