Diagnostic Radiation May Up Risk for Testicular Cancer

MONDAY, Nov. 16, 2020 — The risk for testicular germ cell tumor (TGCT) is elevated in association with increased exposure to lower abdominal and pelvic diagnostic radiation, according to a study published online Nov. 11 in PLOS ONE.

Kevin T. Nead, M.D., M.Phil., from the University of Pennsylvania in Philadelphia, and colleagues examined the association between reported exposure to diagnostic radiation and TGCT risk in a case-control study of men recruited from hospital- and population-based settings. Exposures to X-ray or computed tomography (CT) below the waist and lower gastrointestinal (GI) series or barium enema, including X-rays to the colon, were reported and a combined measure of exposure was derived. Data were included for 315 men with TGCT and 931 men without TGCT.

The researchers found that the risk for TGCT was significantly elevated among those reporting at least three exposures to X-ray or CT, lower GI series or barium enema, and the combined exposure variable compared with no exposures (odds ratios, 1.78 [95 percent confidence interval (CI), 1.15 to 2.76; P = 0.010], 4.58 [95 percent CI, 2.39 to 8.76; P < 0.001], and 1.59 [95 percent CI, 1.05 to 2.42; P = 0.029], respectively). Those exposed to diagnostic radiation at age 0 to 10 years had an elevated risk for TGCT compared with those first exposed at age 18 years or later, although the association did not reach statistical significance (odds ratio, 2.00; 95 percent CI, 0.91 to 4.42; P = 0.086).

“If our results are validated, efforts to reduce medically unnecessary and avoidable testicular exposure should be considered, in part through efforts to reduce radiation dose and optimize shielding practices when appropriate,” the authors write.

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