TY - JOUR
T1 - Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults
AU - Bosch de Basea Gomez, Magda
AU - Thierry-Chef, Isabelle
AU - Harbron, Richard
AU - Hauptmann, Michael
AU - Byrnes, Graham
AU - Bernier, Maria Odile
AU - Le Cornet, Lucian
AU - Dabin, Jérémie
AU - Ferro, Gilles
AU - Istad, Tore S.
AU - Jahnen, Andreas
AU - Lee, Choonsik
AU - Maccia, Carlo
AU - Malchair, Françoise
AU - Olerud, Hilde
AU - Simon, Steven L.
AU - Figuerola, Jordi
AU - Peiro, Anna
AU - Engels, Hilde
AU - Johansen, Christoffer
AU - Blettner, Maria
AU - Kaijser, Magnus
AU - Kjaerheim, Kristina
AU - Berrington de Gonzalez, Amy
AU - Journy, Neige
AU - Meulepas, Johanna M.
AU - Moissonnier, Monika
AU - Nordenskjold, Arvid
AU - Pokora, Roman
AU - Ronckers, Cecile
AU - Schüz, Joachim
AU - Kesminiene, Ausrele
AU - Cardis, Elisabeth
N1 - Score=10
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/11/9
Y1 - 2023/11/9
N2 - 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.
AB - 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.
KW - Hematologic neoplasms
KW - Neoplasms
KW - Radiation-induced
KW - Radiation dosage
KW - Radiation exposure
KW - Tomography
KW - X-Ray computed
UR - http://www.scopus.com/inward/record.url?scp=85176241699&partnerID=8YFLogxK
U2 - 10.1038/s41591-023-02620-0
DO - 10.1038/s41591-023-02620-0
M3 - Article
C2 - 37946058
AN - SCOPUS:85176241699
SN - 1078-8956
VL - 29
SP - 3111
EP - 3119
JO - Nature Medicine
JF - Nature Medicine
IS - 12
ER -