Anti-doping testing in sports has the potential for early detection of testicular cancer, newly published research has found.

While incidental cancer diagnoses are rare during anti-doping testing, they highlight a critical health issue — testicular cancer can affect even apparently healthy young athletes. 

The research, published in Sports Medicine Australia’s Journal of Science and Medicine in Sport, found that early detection and treatment can lead to full recovery, allowing individuals to return to high-level sports and other pursuits.

Researchers said this dual role of anti-doping tests underscores the primary goal of ensuring fair play while illustrating the potential for early health screenings to be integrated into testing protocols. 

Experts caution that any integration must be carefully designed to avoid detracting from the main objectives of anti-doping programs.

The new research would explore how health screenings might responsibly complement anti-doping efforts and offer an extra layer of benefit to athletes and the broader community.

The researchers said further collaboration and research are needed.

Anti-doping tests are intended to maintain fairness in competition and protect athletes’ health by discouraging the use of substances that can have harmful side effects.

The test capable of detecting testicular cancer is for human chorionic gonadotrophin (hCG), a glycoprotein that stimulates the production of testosterone in males, which is crucial for developing and maintaining male reproductive health, the researchers said.

Normally, hCG is either undetectable or found at very low levels in urine from healthy, non-doping males. 

Apart from substance abuse, elevated levels of hCG and hCG-core fragments can be produced by testicular cancers and rarely from extra-testicular germ cell tumors, researchers said.

In recent years there have been some media reports of top athletes being diagnosed with testicular cancer as a result of testing positive for high hCG concentrations detected during routine doping controls, they said.

The research reports on the publicly-available and  identified athletes who were diagnosed with testicular cancer following a positive doping test since 2010. 

All these athletes were under 35 and almost all were diagnosed at an early stage, allowing a complete and rapid return to play in most cases. Only one case resulted in a diagnosis of metastatic disease that led to the premature death of the young athlete.

The authors concluded that “this unexpected intersection of sports, health, and awareness serves as a reminder of the vital role sports can play in driving public health initiatives”.

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About JSAMS

The Journal of Science and Medicine in Sport (JSAMS) is published by Sports Medicine Australia.

The journal provides high-quality, original research papers to keep Sports Medicine Australia members and subscribers informed of developments in the areas of sports exercise and medicine, sports injury, physical activity, and sports exercise and science.