Lower abdominal and pelvic radiation and testicular germ cell tumor risk

• Published in: PloS one 2020-11, Vol.15 (11), p.e0239321
• Main Authors: Nead, Kevin T, Mitra, Nandita, Weathers, Benita, Pyle, Louisa, Emechebe, Nnadozie, Pucci, Donna A, Jacobs, Linda A, Vaughn, David J, Nathanson, Katherine L, Kanetsky, Peter A
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Cavity - radiation effects; Adolescent; Adult; Age; Age Factors; Barium; Biology and Life Sciences; Body mass; Body mass index; Body size; Cancer; Case-Control Studies; Child; Child, Preschool; Colon; Computed tomography; Cryptorchidism; Cryptorchidism - etiology; Diagnostic Imaging - adverse effects; Diagnostic systems; Drug dosages; Epidemiology; Exposure; Genetics; Health aspects; Hematology; Hospitals; Humans; Infant; Infant, Newborn; Informed consent; Logistic Models; Male; Medical diagnosis; Medicine; Medicine and Health Sciences; Middle Aged; Neoplasms, Germ Cell and Embryonal - etiology; Oncology; Pelvis - radiation effects; Physical Sciences; Questionnaires; Radiation; Radiation dosage; Radiation effects; Radiation Injuries - etiology; Research and Analysis Methods; Risk; Risk Factors; Statistical analysis; Testes; Testicular cancer; Testicular Neoplasms - etiology; Testis - radiation effects; Tumors; X-rays; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0239321

Testicular germ cell tumor (TGCT) incidence has increased in recent decades along with the use and dose of diagnostic radiation. Here we examine the association between reported exposure to diagnostic radiation and TGCT risk. We conducted a case-control study of men with and without TGCT recruited from hospital- and population-based settings. Participants reported on exposures to 1) x-ray or CT below the waist and 2) lower GI series or barium enema, which consists of a series of x-rays of the colon. We also derived a combined measure of exposure. We used logistic regression to determine the risk of developing TGCT according to categories of exposures (0, 1-2, or ≥3 exposures) and age at first exposure, adjusting for age, year of birth, race, county, body mass index at diagnosis, family history of TGCT, and personal history of cryptorchidism. There were 315 men with TGCT and 931 men without TGCT in our study. Compared to no exposures, risk of TGCT was significantly elevated among those reporting at least three exposures to x-ray or CT (OR≥3 exposures, 1.78; 95% CI, 1.15-2.76; p = 0.010), lower GI series or barium enema (OR≥3 exposures, 4.58; 95% CI, 2.39-8.76; p