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

Magda Bosch de Basea Gomez, Isabelle Thierry-Chef, Richard Harbron, Michael Hauptmann, Graham Byrnes, Maria Odile Bernier, Lucian Le Cornet, Jérémie Dabin, Gilles Ferro, Tore S. Istad, Andreas Jahnen, Choonsik Lee, Carlo Maccia, Françoise Malchair, Hilde Olerud, Steven L. Simon, Jordi Figuerola, Anna Peiro, Hilde Engels, Christoffer JohansenMaria Blettner, Magnus Kaijser, Kristina Kjaerheim, Amy Berrington de Gonzalez, Neige Journy, Johanna M. Meulepas, Monika Moissonnier, Arvid Nordenskjold, Roman Pokora, Cecile Ronckers, Joachim Schüz, Ausrele Kesminiene, Elisabeth Cardis

Research outputpeer-review

2 Scopus citations


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.

Original languageEnglish
Pages (from-to)3111-3119
Number of pages9
JournalNature Medicine
Issue number12
StatePublished - 9 Nov 2023

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology

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