Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults

被引：149

作者：

de Basea, Magda Bosch ^{[1
,2
,3
]}

Thierry-Chef, Isabelle ^{[1
,2
,3
,4
]}

Harbron, Richard ^{[1
,2
,3
,5
]}

Hauptmann, Michael ^{[6
]}

Byrnes, Graham ^{[4
]}

Bernier, Maria-Odile ^{[7
]}

Le Cornet, Lucian ^{[8
,9
]}

Dabin, Jeremie ^{[10
]}

Ferro, Gilles ^{[4
]}

Istad, Tore S. ^{[11
]}

Jahnen, Andreas ^{[12
]}

Lee, Choonsik ^{[13
]}

Maccia, Carlo ^{[14
]}

Malchair, Francoise ^{[14
]}

Olerud, Hilde ^{[11
,15
,16
]}

Simon, Steven L. ^{[13
]}

Figuerola, Jordi ^{[1
,2
,3
]}

Peiro, Anna ^{[1
,2
,3
]}

Engels, Hilde ^{[10
]}

Johansen, Christoffer ^{[17
]}

Blettner, Maria ^{[8
]}

Kaijser, Magnus ^{[18
]}

Kjaerheim, Kristina ^{[19
]}

Berrington de Gonzalez, Amy ^{[13
,20
]}

Journy, Neige ^{[7
,21
]}

Meulepas, Johanna M. ^{[22
]}

Moissonnier, Monika ^{[4
]}

Nordenskjold, Arvid ^{[18
]}

Pokora, Roman ^{[8
]}

Ronckers, Cecile ^{[6
,8
]}

Schuz, Joachim ^{[4
]}

Kesminiene, Ausrele ^{[4
]}

Cardis, Elisabeth ^{[1
,2
,3
]}

机构：

[1] Barcelona Inst Global Hlth ISGlobal, Barcelona, Spain

[2] Pompeu Fabra Univ, Barcelona, Spain

[3] Inst Salud Carlos III, Spanish Consortium Res & Publ Hlth CIBERESP, Madrid, Spain

[4] Int Agcy Res Canc IARC WHO, Environm & Lifestyle Epidemiol Branch, Lyon, France

[5] Newcastle Univ, Populat Hlth Sci Inst, Newcastle Upon Tyne, England

[6] Brandenburg Med Sch, Inst Biostat & Registry Res, Neuruppin, Germany

[7] Inst Radioprotect & Surete Nucleaire, Fontenay Aux Roses, France

[8] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Inst Med Biostat Epidemiol & Informat, Mainz, Germany

[9] German Canc Res Ctr, Heidelberg, Germany

[10] Belgian Nucl Res Ctr SCK CEN, Mol, Belgium

[11] Norwegian Radiat & Nucl Safety Author, Oslo, Norway

[12] Luxembourg Inst Sci & Technol, Esch Sur Alzette, Luxembourg

[13] NCI, Div Canc Epidemiol & Genet, NIH, Rockville, MD USA

[14] Ctr Assurance Qual Applicat Technol Domaine Sante, Sevres, France

[15] Norwegian Radiat Protect Author, Osteras, Norway

[16] Univ South Eastern Norway, Kongsberg, Norway

[17] Rigshosp, Ctr Surg & Canc, Canc Late Effect Res Oncol Clin CASTLE, Copenhagen, Denmark

[18] Karolinska Univ Hosp, Dept Neuroradiol, Stockholm, Sweden

[19] Canc Registry Norway, Dept Res, Oslo, Norway

[20] Inst Canc Res, London, England

[21] Paris Saclay Univ, French Natl Inst Hlth & Med Res INSERM Unit 1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France

[22] Netherlands Canc Inst, Amsterdam, Netherlands

来源：

NATURE MEDICINE | 2023年 / 29卷 / 12期

关键词：

HEALTH-ORGANIZATION CLASSIFICATION; ATOMIC-BOMB SURVIVORS; COMPUTED-TOMOGRAPHY; BRAIN-TUMORS; IONIZING-RADIATION; SUBSEQUENT RISK; 2016; REVISION; CANCER-RISK; SCANS; LEUKEMIA;

D O I：

10.1038/s41591-023-02620-0

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

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.

引用

页码：3111 / 3119

页数：17

共 43 条

[1]

[Anonymous], 2013, INT CLASSIFICATION D

[2]

[Anonymous], 2006, HLTH RISKS EXP LOW L

[3]

[Anonymous], 2022, Optimisation of ionising radiation-based medical protocols for diagnostics or therapy

[4]

[Anonymous], 2019, Medical radiation exposure of patients in the United States: recommendations of the National Council on Radiation Protection and Measurements

[5]

[Anonymous], 2022, UNSCEAR 2020/2021 Report Volume I: Evaluation of Medical Exposure to Ionizing Radiation

[6]

[Anonymous], 2007, ANN ICRP, V37, P1, DOI [10.1016/j.icrp.2007.10.003, DOI 10.1016/J.ICRP.2007.10.003]

[7] The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia [J].

Arber, Daniel A. ;

Orazi, Attilio ;

Hasserjian, Robert ;

Thiele, Jurgen ;

Borowitz, Michael J. ;

Le Beau, Michelle M. ;

Bloomfield, Clara D. ;

Cazzola, Mario ;

Vardiman, James W. .

BLOOD, 2016, 127 (20) :2391-2405

[8]

Badia Roca F. B., 2018, rERR: excess relative risk models

[9] Cohort Profile: the EPI-CT study: a European pooled epidemiological study to quantify the risk of radiation-induced cancer from paediatric CT [J].

Bernier, Marie-Odile ;

Baysson, Helene ;

Pearce, Mark S. ;

Moissonnier, Monika ;

Cardis, Elisabeth ;

Hauptmann, Michael ;

Struelens, Lara ;

Dabin, Jeremie ;

Johansen, Christoffer ;

Journy, Neige ;

Laurier, Dominique ;

Blettner, Maria ;

Le Cornet, Lucian ;

Pokora, Roman ;

Gradowska, Patrycja ;

Meulepas, Johanna M. ;

Kjaerheim, Kristina ;

Istad, Tore ;

Olerud, Hilde ;

Sovik, Aste ;

Bosch de Basea, Magda ;

Thierry-Chef, Isabelle ;

Kaijser, Magnus ;

Nordenskjold, Arvid ;

de Gonzalez, Amy Berrington ;

Harbron, Richard W. ;

Kesminiene, Ausrele .

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2019, 48 (02) :379-+

[10] CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data [J].

Bosch de Basea, Magda ;

Espinosa, Ana ;

Gil, Mariona ;

Figuerola, Jordi ;

Pardina, Marina ;

Vilar, Jose ;

Cardis, Elisabeth .

PLOS ONE, 2018, 13 (05)

← 1 2 3 4 5 →