Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults.
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ICR Authors
Authors
Bosch de Basea, M
Thierry-Chef, I
Harbron, R
Hauptmann, M
Byrnes, G
Bernier, M-O
Le Cornet, L
Dabin, J
Ferro, G
Istad, TS
Jahnen, A
Lee, C
Maccia, C
Malchair, F
Olerud, H
Simon, SL
Figuerola, J
Peiro, A
Engels, H
Johansen, C
Blettner, M
Kaijser, M
Kjaerheim, K
Berrington de Gonzalez, A
Journy, N
Meulepas, JM
Moissonnier, M
Nordenskjold, A
Pokora, R
Ronckers, C
Schüz, J
Kesminiene, A
Cardis, E
Thierry-Chef, I
Harbron, R
Hauptmann, M
Byrnes, G
Bernier, M-O
Le Cornet, L
Dabin, J
Ferro, G
Istad, TS
Jahnen, A
Lee, C
Maccia, C
Malchair, F
Olerud, H
Simon, SL
Figuerola, J
Peiro, A
Engels, H
Johansen, C
Blettner, M
Kaijser, M
Kjaerheim, K
Berrington de Gonzalez, A
Journy, N
Meulepas, JM
Moissonnier, M
Nordenskjold, A
Pokora, R
Ronckers, C
Schüz, J
Kesminiene, A
Cardis, E
Document Type
Journal Article
Date
2023-12-01
Date Accepted
2023-09-29
Abstract
Over one million European children undergo computed tomography (CT) scans annually. Although moderate- to high-dose ionizing radiation exposure is an established risk factor for hematological malignancies, risks at CT examination dose levels remain uncertain. Here we followed up a multinational cohort (EPI-CT) of 948,174 individuals who underwent CT examinations before age 22 years in nine European countries. Radiation doses to the active bone marrow were estimated on the basis of body part scanned, patient characteristics, time period and inferred CT technical parameters. We found an association between cumulative dose and risk of all hematological malignancies, with an excess relative risk of 1.96 (95% confidence interval 1.10 to 3.12) per 100 mGy (790 cases). Similar estimates were obtained for lymphoid and myeloid malignancies. Results suggest that for every 10,000 children examined today (mean dose 8 mGy), 1-2 persons are expected to develop a hematological malignancy attributable to radiation exposure in the subsequent 12 years. Our results strengthen the body of evidence of increased cancer risk at low radiation doses and highlight the need for continued justification of pediatric CT examinations and optimization of doses.
Citation
Nature Medicine, 2023, 29 (12), pp. 3111 - 3119
Source Title
Nature Medicine
Publisher
NATURE PORTFOLIO
ISSN
1078-8956
eISSN
1546-170X
1546-170X
1546-170X
Collections
Research Team
Clinical Cancer Epidemiol