Radiation risk overemphasized in testis Ca patients?

The lifetime risks of cancer from medical radiation may be overemphasized relative to more immediate health risks, according to a recent study.

First author Pari Pandharipande, MD, MPH, of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues used computed tomography radiation dose data and mathematical models to better understand the risk-benefit dynamic of medical radiation. They projected outcomes for testicular cancer patients who undergo CT surveillance in the decade after orchiectomy.

Based on the results of their analysis, the authors projected that 33-year-old men with early-stage cancer who undergo CT surveillance incur a slightly higher lifetime mortality risk from testicular cancer compared with potential radiation-induced cancers. Because the testicular cancer risk was more immediate, life expectancy loss attributable to testicular cancer was more than three times greater than life expectancy loss attributable to radiation-induced cancers.

The trends were consistent across all the scenarios studied, and put forth a useful concept to help physicians with decision making, according to the researchers.

"Radiation-induced cancer risks, often discussed at the population level, can be challenging to conceptualize and apply to imaging decisions that have to be made at the patient level," Dr. Pandharipande said. "We as physicians can benefit from dedicated educational efforts to improve decision making and better convey the risks to patients."

Although the study focused on testicular cancer patients, concepts pertaining to the timing of radiation-induced cancer risk translate to other scenarios where CT is needed to avert a more immediate health risk, Dr. Pandharipande noted.

Results from the study were published online in Radiology (Dec. 18, 2012).