Chimney sweeps' carcinoma

Chimney sweep's cancer, also called Soot wart, is a squamous cell carcinoma of the skin of the scrotum. It has the distinction of being the first reported form of occupational cancer, and was initially identified by Percivall Pott in 1775. It was initially noticed as being prevalent amongst chimney sweeps.

Chimney sweeps' carcinoma is a squamous cell carcinoma of the skin of the scrotum. Warts caused by the irritation from soot particles, if not excised, developed into a scrotal cancer. This then invaded the dartos, enlarged the testicle, and proceeded up the spermatic cord into the abdomen where it proved fatal.

Chimney sweeps' carcinoma was first described by Percivall Pott in 1775 who postulated that the cancer was associated with occupational exposure to soot. The cancer primarily affected chimney sweeps who had been in contact with soot since their early childhood. The median age of onset of symptoms in one review was 37.7 years, although boys as young as 8 years old were found to have the disease. It was proposed by W.G. Spencer in 1890 that sweat running down their bodies had caused soot to accumulate in the rugae of the inferior surfaces of the scrotum, with the resulting chronic irritation causing scrotal cancer, but this was shown to be an incorrect artifact of the method used to stain his microscope slides.

In 1922, R.D. Passey, a research physician at Guy’s Hospital in London produced malignant skin tumors in mice exposed to an extract made from soot, demonstrating the presence of carcinogenic substances in soot which were the likely cause of cancer of the scrotum in chimney sweeps.

in the 1930s Ernest Kennaway and James D. Cook of the Research Institute of the Cancer Hospital, London, (later known as the Royal Marsden Hospital) discovered several polycyclic hydrocarbons present in soot that were potent carcinogens: 1,2,5,6-dibenzanthracene; 1,2,7,8-dibenzanthracene; and 1,2-benzpyrene (3) benzo[α]pyrene. DNA consists of sequences of four bases - adenine, thymine, cytosine and guanine - bound to a deoxyribonucleic backbone. Benzo[α]pyrene interacts with deoxyguanosine of the DNA, damaging it and potentially starting the processes that can lead to cancer.

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