Exposure to Tomographic Scans and Cancer Risks

被引:91
作者
Shao, Yu-Hsuan [1 ,2 ]
Tsai, Kevin [1 ]
Kim, Sinae [3 ]
Wu, Yu-Jen [4 ]
Demissie, Kitaw [5 ]
机构
[1] Taipei Med Univ, Coll Med Sci & Technol, Grad Inst Biomed Informat, Taipei, Taiwan
[2] Taipei Med Univ Hosp, Clin Big Data Res Ctr, Taipei, Taiwan
[3] Rutgers Sch Publ Hlth, Dept Biostat, Piscataway, NJ USA
[4] Taipei City Hosp, Div Radiol, Renai Branch, Taipei, Taiwan
[5] SUNY Downtown Med Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Brooklyn, NY USA
关键词
ATOMIC-BOMB SURVIVORS; COMPUTED-TOMOGRAPHY; RADIATION-EXPOSURE; CT SCANS; SUBSEQUENT RISK; ADULT PATIENTS; BRAIN-TUMORS; 2ND CANCERS; LEUKEMIA; PREVALENCE;
D O I
10.1093/jncics/pkz072
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Worldwide use of computed tomography (CT) scans has increased. However, the ionizing radiation from CT scans may increase the risk of cancer. This study examined the association between medical radiation from CT scans and the risk of thyroid cancer, lymphoma, and non-Hodgkin lymphoma (NHL) in adults. Methods: We conducted a nested case-control study in a cohort constructed from a population-based universal health insurance dataset in Taiwan in 2000-2013. In total, 22 853 thyroid cancer, 13 040 leukemia, and 20 157 NHL cases with their matched controls were included. Median follow-up times were 9.29-9.90 years for the three case-control groups. Medical radiation from CT scans was identified through physician order codes in medical insurance data from the index date to 3 years before a cancer diagnosis. Conditional logistic regression modeling was used for the overall and subsets of the population defined by sex and age groups to estimate the odds ratio (OR) and 95% confidence interval (CI) of the cancer risk associated with medical radiation. Results: Exposure to medical radiation from CT scans was associated with elevated risk of thyroid cancer (OR = 2.55, 95% CI = 2.36 to 2.75) and leukemia (OR = 1.55, 95% CI = 1.42 to 1.68). The elevated risk of thyroid cancer and leukemia in association with medical CT was stronger in women than in men. No statistically significant association between the risk of cancer and CT scans was observed in overall patients with NHL (OR = 1.05, 95% CI = 0.98 to 1.12); however, increased risks were found in patients aged 45 years or younger. A clear dose-response relationship was observed in patients 45 years or younger for all three cancers. Conclusions: CT scans may be associated with an increased risk of thyroid cancer and leukemia in adults and in those diagnosed with NHL at a younger age.
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页数:7
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