TCS Daily


Hitting 'Em Where It Hurts

By Brendan O'Neill - June 18, 2002 12:00 AM

LONDON -- Have you 'tested your testicles' lately? Apparently, if you're a man aged between 15 and 34 you should self-examine your private parts at least once a month. You stand naked in front of a full-length mirror after a warm bath, roll each testicle with your fingers to feel for lumps or abnormalities, and then 'talk openly' with your partner, friends or doctor about anything that concerns you ('however small', says one health expert, without a hint of irony).

Testicular cancer awareness campaigns are everywhere in Europe, with TV adverts, TV programmes, magazine features, celebrity advice, books, pamphlets, leaflets, websites and public health announcements encouraging young men to 'get in touch with their testicles'. You can even buy 'aware underwear', which have instructions about how to examine your testicles printed on the inside. But is all of this really necessary?

The UK Cancer Research charity thinks so. According to its latest report, published in June 2002, 'England has one of the highest rates of testicular cancer in Europe'. In fact, 'Europe tops the testicle cancer league', reports the BBC, claiming that 'Germany, France, Italy and England head a "league table" of nations compiled by cancer statisticians'. Researchers claim that testicular cancer, 'the most common cancer in younger men, has risen by 84 percent in the UK since the late 1970s', and that approximately 1800 British men are diagnosed with the disease a year, compared with 850 a year in the late 1970s.

The incidence of the disease is 5.6 cases per 100,000 men in the UK, 5.8 in Italy, 6.3 in France, 6.2 in Sweden and 8.9 in Germany - compared to just 0.6 per 100,000 men in less well-off nations like Korea and Nigeria. '[I]ncidence has risen sharply over the last century', says British cancer researcher Dr Douglas Easton.

Reading recent headlines about the 'Rise of testicular cancer' and 'Europe's testicular tragedy', you could be forgiven for thinking that European men are dropping dead from the disease. In fact, while the incidence of testicular cancer may have risen, deaths from testicular cancer have fallen dramatically. In Britain between 1975 and 1979, there were on average 276 deaths a year from testicular cancer, while between 1995 and 1997 there were on average 96 deaths a year - a fall of 72 percent.

According to Peter Boyle of the Imperial Cancer Research Fund, this trend is repeated across the developed world. 'In spite of the number of cases increasing, deaths from testicular cancer have been declining in North America and Western Europe since the late 1970s', says Boyle - pointing out that 'death rates in men below age 45 have fallen by about a third in the late 1980s compared to rates in the 1970s'. In 1999, just three men aged 15 to 24 and 14 men aged 25 to 34 died from testicular cancer in England and Wales - a total of 17 deaths among eight million young men. In their rush to highlight the rising incidence of testicular cancer, health experts and health pundits often forget to mention that death by testicular cancer is extremely rare - and that it's get rarer all the time.

Of course, many men's health campaigners claim that the number of deaths has fallen precisely as a result of awareness campaigns -- and no doubt there is an element of truth in that. The rising incidence of testicular cancer is surely related to the fact that more young men are checking their testicles -- and with scientific advances and better medical treatment, testicular cancer now has a 95 percent cure rate, making it one of the least fatal forms of cancer you can get. All of this is good news.

But does the actual incidence of testicular cancer, the likelihood of contracting it, justify the ever-present, fear-inducing, panicmongering campaigns that constantly alert young men to the 'dangers' lurking in their underwear? After all, if the incidence of testicular cancer in Europe is approximately 6 cases per 100,000 men, this still makes it an extremely rare disease (which is highly likely to be cured anyway). Young men are more at risk from accidents, injuries, suicide, liver disease, heart conditions, multiple sclerosis and even breast cancer (all of which are also rare), than they are from testicular cancer. So why are teenage and twentysomething men forever being warned about such a rare disease?

Listening to the men's health campaigners and experts behind much of the awareness-raising, you soon realise that the campaigns have less to do with communicating clear facts about the relative risks of contracting testicular cancer, than with making young men into good, responsible, health-obsessed citizens for our health-obsessed age. A common feature of the awareness campaigns is the accusation that young men are 'backward' about their health - that they are too self-confident, cocksure and self-sufficient, and must be brought down a peg or two by being warned to get in touch with their health-aware and vulnerable sides.

According to Professor Lesley Fallowfield of the Cancer Research Psychological Oncology Group: 'Feelings can be quite hard for men to discuss, particularly if it's about things like male cancers which are threatening to their notions of masculinity and manhood. There's also a cultural expectation that "big boys don't cry", and many men do not actually ask about things that trouble them....so we have to find new ways of reaching them.' See how easily men's health experts move from the hard facts about disease to talking about 'feelings', 'cultural expectations' and 'notions of masculinity'? This is typical of testicular cancer awareness campaigns - where the target seems to be less men's physiological health problems than their attitudes.

Much of Europe's new and ever-expanding men's health industry seems keen to challenge men's attitudes and behaviour. It seems particularly keen to remind young men that they're not invincible - that for all their youthful flair, ambition, confidence and zest, there is a possibility (however slim and remote) that they could be struck down by a potentially fatal disease at any moment. This kind of awareness-raising is likely to have a detrimental impact on young men, turning them into fearful and inward-looking creatures, who constantly fret about their own bodies and personal health - even though the vast majority of them are in good physical and mental condition.

We live in an age where health awareness is like a new religion, and where those who don't obsess about their health (traditionally young men) are the new heretics. Health experts and campaigners want to make young men more health-conscious -- and what better way to do that than grabbing them by the... well, you know?

Health experts should leave young men, and young men's testicles, alone.

Brendan O'Neill is assistant editor of spiked.
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