Autoexames mamário e testicular nos rastreamentos oncológicos: uma questão de prevenção quaternária? / Breast and testicular self-examinations in cancer screening: a matter of quaternary prevention? / Autoexámenes testicular e mamario en tamizaje de cáncer: ¿una cuestión de prevención cuaternaria?

Os cuidados em saúde incluem atitudes preventivas importantes que se dividem nas categorias primária, secundária, terciária e quaternária. A prevenção quaternária consiste no abandono de procedimentos desenvolvidos pelos profissionais de saúde cujos benefícios são duvidosos e cujos danos são desconhecidos ou notórios. O aconselhamento para a realização dos autoexames como métodos de rastreamento dos cânceres mamário e testicular é uma temática de prevenção quaternária. Não existem ensaios clínicos aleatórios e controlados que testem a efetividade e segurança do autoexame testicular. Quanto ao autoexame mamário, foi provado em dois grandes ensaios clínicos que causa dano como método de rastreamento (ansiedade, biópsias que detetam lesões benignas), sem qualquer benefício em termos de taxa de mortalidade. Os profissionais de saúde deverão saber que a ausência deste tipo de aconselhamento resulta, paradoxalmente, em proteção da saúde, especialmente para o rastreamento do câncer mamário. Na realidade, é um exemplo de como menos transforma-se em mais. clínicos que causa dano como método de rastreamento (ansiedade, biópsias que detetam lesões benignas), sem qualquer benefício em termos de taxa de mortalidade. Os profissionais de saúde deverão saber que a ausência deste tipo de aconselhamento resulta, paradoxalmente, em proteção da saúde, especialmente para o rastreamento do câncer mamário. Na realidade, é um exemplo de como menos transforma-se em mais.

Health care includes important preventive attitudes that are divided into four categories: primary, secondary, tertiary, and quaternary. Quaternary prevention refers to the avoidance of the implementation of procedures whose benefits are doubtful and damages are unknown or notorious. Counseling for self-examinations in breast and testicular cancer screenings can fall under the purview of quaternary prevention. However, there is a lack of randomized controlled trials that examine the effectiveness and safety of testicular self-examination. Meanwhile, in two large randomized controlled clinical trials, breast self-examination has been proven to cause harm (anxiety and biopsies to detect benign lesions) as a screening method, with no benefit in terms of mortality rates. Healthcare professionals should be aware that the absence of counseling in this context, paradoxically results in the protection of health, especially with reference to breast cancer screening. It is a simple example of how less is more.

La atención a la salud incluye actitudes preventivas importantes que se dividen en primaria, secundaria, terciaria y cuaternaria. La prevención cuaternaria implica el abandono de algunos procedimientos realizados por profesionales, cuyos beneficios son dudosos y cuyos daños son desconocidos o notorios. La promoción de los autoexámenes de mamas y testicular en cribado de cáncer puede ser una cuestión de prevención cuaternaria. Hay una falta de ensayos controlados aleatorios que podría poner a prueba la eficacia y la seguridad del auto examen testicular. En cuanto al autoexamen de mamas, en dos grandes ensayos clínicos se ha demostrado que causa daño (ansiedad, biopsias para detectar lesiones benignas) como método de cribado, sin ningún beneficio en las tasas de mortalidad. Los profesionales de salud deben ser conscientes de que la ausencia de este tipo de consejo resulta, paradójicamente, en protección de la salud, especialmente para el cribado del cáncer de mama. En realidad, es un ejemplo de cómo con menos se hace más.

Body esteem and self-examination in British men and women

Breast and testicular cancers affect a substantial and increasing proportion of the global population. Self-examination encourages early detection and treatment of these cancers, which positively impacts on patient quality of life and survival. The present study investigated the role of body esteem in breast and testicular self-examination. Men [N = 60] and women [N = 90] recruited from a British University completed the body esteem scale and either the testicular self-examination or breast self-examination questionnaire. Logistic regression models revealed that body esteem predicted women's intention to engage in breast self-examination. Women with higher levels of sexual attractiveness and those with lower levels of weight concern were more likely to report that they would regularly self-examine in the future. Body esteem did not however, distinguish between those women that did or did not currently self-examine or predict men's current or intended testicular self-examination. The findings have implications for the promotion of self-examination and highlight an emerging area of preventive health research

Estratégias de prevenção para câncer de testículo e pênis: revisão integrativa / Prevention strategies for testicular and penile cancer: an integrative review / Estrategias de prevención del cáncer de testículo y pene: revisión integradora

Cânceres de testículo e pênis são doenças que acometem pequena parcela da população, mas geralmente são agressivas principalmente pelo impacto psicológico que exercem sobre os pacientes. Este estudo buscou identificar evidências de estratégias preventivas para tais cânceres. Foi realizada revisão integrativa de literatura, nas bases de dados Biblioteca COCHRANE, PubMed/MEDLINE, LILACS, BDENF e CINAHL, utilizando os descritores controlados: promoção da saúde, fatores de risco, prevenção primária e neoplasias urogenitais; e os não controlados: prevenção, câncer de pênis, câncer de testículo. Os estudos foram unânimes ao identificar, para o câncer de testículo, o autoexame do órgão; para o câncer de pênis, evidenciou-se a circuncisão como fator protetor, a prevenção de infecção sexualmente transmissível e a adequada higiene íntima. Os enfermeiros devem assumir a função de promotor da saúde, tendo em vista a importância dessa atitude frente à prevenção de doenças.

Testicular and penile cancers are genital disorders that affect a small part of population, but are generally aggressive mainly because of the dramatic psychological effect they impose over patients. The purpose of this study was to identify evidence concerning preventing strategies for the referred types of cancer. An integrative literature review was performed on the COCHRANE, PubMed/MEDLINE, LILACS, BDENF and CINAHL databases using the following controlled descriptors: health promotion, risk factors, primary prevention, and urogenital neoplasms; and uncontrolled descriptors: prevention, penile cancer, testicle cancer. The studies were unanimous in concluding that self-examination of testicles is the best way to identify a possible event of testicular cancer. Circumcision, prevention for sexual transmission diseases and adequate hygiene were the most important manners for penile cancer prevention. Nurses should assume the role for general and specific health promotion, considering the major impact it would have for prevention of diseases, especially for the urogenital cancers studied in this review.

El cáncer de testículo y de pene son enfermedades sufridas por un pequeño segmento de la población, generalmente son agresivas, sobre todo por el impacto psicológico que ejercen sobre los pacientes. Este estudio buscó identificar evidencias de estrategias preventivas para tales cánceres. Se realizó una revisión integradora de literatura en las bases de datos Biblioteca COCHRANE, PubMed/MEDLINE, LILACS, BDENF y CINAHL, utilizando los descriptores controlados: promoción de la salud, factores de riesgo, prevención primaria y neoplasias urogenitales; y los no controlados: prevención, cáncer de pene, cáncer de testículo. Los estudios fueron unánimes al identificar, para el cáncer de testículo, el autoexamen del órgano; para el cáncer de pene se evidenció que la circuncisión es un factor de protección, así como la prevención de la infección sexualmente transmisible y la adecuada higiene íntima. Los enfermeros deben asumir la función de promotor de la salud, teniendo en vistas la importancia de tal actitud en la prevención sanitaria.

Adolescent student's compliance with testicular self examination

To determine what adolescents students know or feel about testicular cancer, (TC) and the testicular self examination, (TSE), technique, 127 males students (mean age 16.14 years) were given a 21 item questionnaire. The role of the primary physician and the role of written and visual educational material were assessed for effectiveness in increasing the regular performance of monthly testicular self examination by male students at a Health Education Course at Cervantes Public School at Bayamón, P.R. Out of 127 male student, only 2.4, (n = 3), initially knew about the symptoms of TC. Analysis of the attitude and knowledge questions revealed that respondents were not sure about general concepts in TC and, were not sure that this cancer could be self diagnosed. This study pretends to assess the effects of modeling and guiding practice as components within a comprehensive testicular self examination education program for adolescents male students. Three groups were studied from 10th, 11th, and 12th, grade. The variables investigated were knowledge of testicular cancer, attitudes toward testicular cancer, and frequency of self reported testicular self examination. The participants then received written material plus a physician's lecture on TC and TSE. Upon follow up, 87.5, (n = 113) of the students reported performing monthly TSE, (P < 0.001), a statistically significant increase in performance. Although 20.3 (n = 26) reported having a physical examination by a physician within the previous 3 months, less than 4.7, (n = 6) reported being taught TSE by a physician. Physicians need to educate males about testicular cancer and its early detection