Testicular Cancer Screening: What You Need to Know
Testicular cancer is the most common cancer in men aged 15–40 in the UK — and it has a five-year survival rate above 95% when caught at stage 1. A consultant sonographer explains the screening pathway, the role of ultrasound, and what to do if you find a lump.
- Men's Health
- Updated July 2026
Testicular Cancer: The Basics
Testicular cancer is rare in absolute terms — approximately 2,400 new cases are diagnosed in the UK each year — but it is the most common cancer in men aged 15–40. The good news is that it is also one of the most treatable cancers: the overall five-year survival rate is above 95%, and for stage 1 disease (confined to the testis), it is above 98%.
The key to those outcomes is early detection. A testicular tumour that is found before it has spread beyond the testis is treated with orchidectomy (surgical removal of the affected testis) and, in most cases, requires no further treatment or only a short course of chemotherapy. A tumour found after it has spread to lymph nodes or distant organs requires more intensive treatment and carries a lower survival rate — though still significantly higher than most other cancers.
Who Is at Higher Risk?
| Risk Factor | Relative Risk Increase |
|---|---|
| Undescended testis (cryptorchidism) — corrected or uncorrected | 3–5× increased risk |
| Personal history of testicular cancer in the other testis | 12–18× increased risk |
| Family history (father or brother with testicular cancer) | 4–6× increased risk |
| Testicular microlithiasis with additional risk factors | Requires annual self-examination and clinical follow-up |
| Klinefelter syndrome | Increased risk of mediastinal germ cell tumours |
Men with any of these risk factors should perform monthly testicular self-examination and discuss their screening options with their GP.
Symptoms to Know
The most common presentation of testicular cancer is a painless lump or swelling in one testis. The word "painless" is important — many men delay seeking assessment because they expect cancer to hurt. It often does not, particularly in the early stages. Other symptoms include:
- A feeling of heaviness or dragging in the scrotum
- A dull ache in the lower abdomen, back, or groin
- A change in the size or firmness of one testis
- A sudden collection of fluid in the scrotum (hydrocele)
- Breast tenderness or growth (gynaecomastia) — caused by hormones produced by some tumour types
Any of these symptoms — particularly a new lump or swelling — should be assessed within days, not weeks. See: Testicular Lumps or Swelling: Could It Be Cancer?
The Screening Pathway
There is no national population-based testicular cancer screening programme in the UK — unlike breast or cervical cancer screening. The primary screening tool is testicular self-examination (TSE), which is recommended monthly for men aged 15–40 and for men of any age with identified risk factors.
Step 1 — Monthly Self-Examination
Perform a self-examination once a month, ideally after a warm shower or bath when the scrotal skin is relaxed. Roll each testis gently between the thumb and fingers, feeling for any new lump, area of firmness, or change in size or texture. The epididymis — the soft, rope-like structure at the back of each testis — is a normal finding; a lump within the testis itself is not.
Step 2 — GP Assessment
If you find a new lump or change, see your GP. Under NICE guideline NG12, a GP should refer you urgently (two-week wait) to urology if they find a testicular mass on examination. A private scrotal ultrasound can be booked the same day and provides the imaging that the GP or urologist will need to act on the finding.
Step 3 — Scrotal Ultrasound
Scrotal ultrasound is the definitive imaging investigation for a testicular lump. It distinguishes between a benign extratesticular finding (epididymal cyst, hydrocele, varicocele) and a solid intratesticular mass with high accuracy. A solid intratesticular mass is treated as testicular cancer until proven otherwise and requires same-day urology referral. See: Book Testicular Ultrasound Scan — £235
Step 4 — Tumour Markers and Staging
If ultrasound identifies a suspicious intratesticular mass, blood tests for tumour markers (AFP, beta-HCG, LDH) are taken before orchidectomy — the surgical removal of the affected testis, which is both the definitive treatment and the histological diagnosis. CT scanning of the chest, abdomen, and pelvis is used to stage the disease after orchidectomy.
From Our Practice
The pattern we see most consistently in men presenting for testicular cancer screening is a man in his late 20s or 30s who has found a lump and has been monitoring it for two to four weeks before booking a scan. The delay is understandable but unnecessary — the scan takes 20 minutes and provides a definitive answer the same day.
In the majority of cases, the lump is benign. An epididymal cyst, a small hydrocele, or a varicocele accounts for most presentations. The patient leaves with a written report confirming the benign finding and clear advice on when to return if anything changes. The reassurance is clinically valuable and resolves the anxiety that drove the booking.
In a smaller proportion of cases, the scan identifies a solid intratesticular mass. These patients are told clearly and calmly what the scan has found, what it means, and what needs to happen next. A referral letter is prepared immediately. The patient is advised to contact their GP or attend a urology clinic the same day. The speed of that pathway — from lump found to specialist referral in a single afternoon — is what private diagnostic ultrasound provides.
The one consistent observation across all of these cases is that earlier is better. The men who present within a week of finding a change have the best outcomes — not because the scan is more accurate, but because the clinical pathway that follows can begin sooner.
Observations above are drawn from composite patterns across our patient population, not from any individual case.
Testicular Cancer Screening FAQs
Is there an NHS testicular cancer screening programme?
No. There is no national population-based testicular cancer screening programme in the UK. The primary screening tool is monthly testicular self-examination, which is recommended for men aged 15–40 and for men of any age with identified risk factors (undescended testis, family history, previous testicular cancer).
Can a blood test diagnose testicular cancer?
Tumour markers (AFP, beta-HCG, LDH) are elevated in some types of testicular cancer and are used for staging and monitoring after diagnosis — but they are not reliable as a primary screening test. A normal tumour marker result does not exclude testicular cancer. Scrotal ultrasound is the definitive investigation for a suspected testicular mass.
What happens if the ultrasound finds something suspicious?
If the scan identifies a solid intratesticular mass, you will be told clearly in the room what has been found and what needs to happen next. A written report is prepared immediately and you will be advised to contact your GP or attend a urology clinic the same day. The report uses the clinical language that the receiving clinician needs to act on it promptly under the two-week wait pathway.
Sources
- National Institute for Health and Care Excellence. Suspected cancer: recognition and referral (NG12). NICE, 2015 (updated 2023). nice.org.uk/guidance/ng12
- Cancer Research UK. Testicular cancer statistics. Accessed July 2026. cancerresearchuk.org
- Albers, P., et al. "EAU Guidelines on Testicular Cancer." European Urology 48.6 (2005): 885–894.
- Sonoworld clinical imaging team. Composite practice patterns — Sonoworld Diagnostic Services, Marylebone, London. July 2026.
Book a Testicular Ultrasound Scan
£235 · Same-day appointments available · No GP referral needed · Verbal results in the room · Written report the same day
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