Diagnostic Imaging may Boost Testicular Cancer Risk

Early and repeated exposures to diagnostic imaging, namely X-rays and CT scans, may boost testicular cancer risk, suggesting a new study from Penn Medicine researchers published online today in PLOS ONE.

"The steady rise in //testicular germ cell tumor (TGCT) cases over the past three or four decades suggests there is an environmental exposure risk at play, but no definitive risk factor has ever been identified," said senior author Katherine L. Nathanson, MD, deputy director of Penn's Abramson Cancer Center and Pearl Basser Professor of BRCA-Related Research in the Perelman School of Medicine at the University of Pennsylvania.

Testicular Cancer - Risk Factors - Symptoms - Diagnosis - Staging - Treatment - Prognosis
A person with testicular cancer may have a testicle that is three times its original size. The most cited risk factor is undescended testes.

‘Radiation is a known risk factor for cancer due to its ability to damage DNA. When cells are unable to repair damaged DNA appropriately, cancer-causing genetic mutations may result.’

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In men, the increased use of diagnostic radiation below the waist over that same time may contribute to the testicular cancer rise in incidence.

Kevin Nead, MD, who conducted the study while in the department of Radiation Oncology at Penn and is now at MD Anderson Cancer Center, serves as the lead author.

Testicular germ cell tumor is the most common cancer in the United States and Europe in men between the ages of 15 and 45. The incidence rate has increased from about three out 100,000 men in 1975 to six out of 100,000 men today. Nearly 9,500 cases will be diagnosed by the end of 2020.

X-Ray - Overview
Encyclopedia section of medindia gives a brief Overview of X-Ray

Researchers conducted an observational study of 1,246 men between the ages of 18 and 55 with and without testicular cancer at Penn Medicine.

The participants completed a questionnaire that elicited information on known and presumptive risk factors for testicular cancer and diagnostic imaging during their lifetime, including the location on the body and number of exposures, prior to their diagnosis. Tumor samples were also collected.

Computed Tomography Scan (CT Scan)
Computed Tomography (CT) scan is a type of medical examination that uses X-rays and computer processing to create sectional images of the body to provide more efficient results than X-rays.

The study found a higher testicular cancer risk among men reporting at least three exposures to X-ray, including a colon X-ray, and CT below the waist, compared to men with no such exposure.

People with three or more exposures to diagnostic radiation had a 59 percent increased risk of testicular cancer than individuals with no exposures to diagnostic radiation.

Quiz on Testicular Cancer
Testicular cancer affects one or both testicles (also called testes or gonads). Testicles are a pair of male sex organs that produce and store sperm. Testicles are located under the penis in a sac-like pouch called the scrotum.

Risk of testicular cancer was also elevated for those exposed to diagnostic radiation during the first decade of their life, compared to those first exposed at age 18 years or later.

"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 wrote.

Source-Medindia