Scottish referral guidelines for suspected cancer
This cancer is relatively rare, with around 185 new cases per year, of which approximately 70% are in males aged 15 to 45 years1.
Testicular cancer
Urgent suspicion of cancer (USC) referral
Refer a person with any of the following to the Urology Service as a USC:
- Non-painful enlargement or change in shape or texture of the body of the testis
- Epididymo-orchitis not improving after two weeks of antibiotics
- USS suggestive of testicular cancer
Referral pathways can vary locally, and, in some areas, the first step may be USC ultrasound scan referral. Local referral pathways should be followed to avoid any delay in triage.
Assessment for suspected testicular cancer
Clinical features include:
- Swelling or lump in the testis or scrotum
- Dull ache in the abdomen or groin
Solid swellings affecting the body of the testis have a more than 50% chance of being cancer. Testicular cancers have the potential to progress rapidly.
Consider testicular examination for any male presenting with abdominal or groin pain, testicular pain or swelling.
Consider a testicular USS for men with unexplained or persistent symptoms despite a normal examination.