What is the appropriate screening for the male and female siblings of a man with germ-cell testicular cancer diagnosed as stage 3 at age 22? The family history includes a paternal history of colon cancer at age 45 and a paternal aunt with thyroid cancer.
—Michael T. Vest, DO, Columbus, Ga.

The familial incidence of testicular tumors is uncommon. However, susceptibility genes are being explored, and families with more than one case of germ-cell tumor have been reported. The best screening is regular manual examination of the testes for male siblings and gynecologic examination of the ovaries for female siblings of this patient.
—Gwen L. Nichols, MD (102-9)

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