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New research by Michael Hauptmann and colleagues suggests that abdominal radiotherapy for testicular cancer substantially increases the risk of developing secondary gastric cancer. Risk remained elevated for several decades after treatment. An increased risk of second malignancies—gastric cancer being of particular concern—have been noted in survivors of testicular cancer, about 10–15 years after initial diagnosis. However, Hauptmann and colleagues noted that, although often attributed to radiotherapy, the effects of radiation dose to the stomach on the incidence of gastric cancer have not been assessed in large studies. From 22 269 5-year survivors of testicular cancer (diagnosed during 1959–87), 272 patients with testicular cancer, including 92 patients who developed gastric cancer (diagnosed during 1975–2004) and 180 matched
controls were identified. The authors reported a cumulative incidence of second primary gastric cancer of 0·30% (95% CI 0·20–0·39) at 15 years after initial diagnosis and 1·45% (1·15–1·74) at 30 years. Radiotherapy substantially increased the risk of developing gastric cancer (odds ratio [OR] 5·9 [95% CI 1·7–20·7]). Compared with matched controls, increasing radiotherapy dose increased the risk of developing gastric cancer (10 Gy [OR 2·0, 95% CI 0·5–8·7], 30 Gy [7·2, 2·1–24·9], and 50 Gy [20·5, 3·7–114·3]; p-trend
New research by Michael Hauptmann and colleagues suggests that abdominal radiotherapy for testicular cancer substantially increases the risk of developing secondary gastric cancer. Risk remained elevated for several decades after treatment. An increased risk of second malignancies—gastric cancer being of particular concern—have been noted in survivors of testicular cancer, about 10–15 years after initial diagnosis. However, Hauptmann and colleagues noted that, although often attributed to radiotherapy, the effects of radiation dose to the stomach on the incidence of gastric cancer have not been assessed in large studies. From 22 269 5-year survivors of testicular cancer (diagnosed during 1959–87), 272 patients with testicular cancer, including 92 patients who developed gastric cancer (diagnosed during 1975–2004) and 180 matched
controls were identified. The authors reported a cumulative incidence of second primary gastric cancer of 0·30% (95% CI 0·20–0·39) at 15 years after initial diagnosis and 1·45% (1·15–1·74) at 30 years. Radiotherapy substantially increased the risk of developing gastric cancer (odds ratio [OR] 5·9 [95% CI 1·7–20·7]). Compared with matched controls, increasing radiotherapy dose increased the risk of developing gastric cancer (10 Gy [OR 2·0, 95% CI 0·5–8·7], 30 Gy [7·2, 2·1–24·9], and 50 Gy [20·5, 3·7–114·3]; p-trend
