|
|
Meta-analysis of cohort studies on radiation exposure from CT scans in childhood and subsequent cancer risk of leukaemia and brain tumors |
NIU Yating1, SU Yinping1, NIU Yantao2, SUN Quanfu1 |
1. Key Laboratory of Radiological Protection and Nuclear Emergency, China CDC, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100086 China; 2. Department of Radiology, Beijing Tongren Hospital, Capital Medical University |
|
|
Abstract Objective To quantitatively estimate the radiation exposure from CT scans in childhood and subsequent cancer risk of leukemia and brain tumors.Methods We retrieved six databases, including Wanfang Database, China National Knowledge Infrastructure, China Biology Medicine disc, MEDLINE, Pubmed, The Cochrane Library, and summarized large-scale cohort studies on CT scans in childhood and subsequent cancer risk which published at home and abroad before 2019. Meta-analysis was performed using relative risk (RR) and its 95% confidence intervals.Results There are five literatures included the analysis. The RR between leukemia and brain tumors was 1.59 (95% CI: 1.24, 2.05) and 2.07 (95% CI: 1.50, 2.86) respectively. CT scans increased the risk of leukemia and brain tumors.Conclusion Radiation exposure of CT scans in childhood can increase the risk of leukemia and brain tumors. It is important to reduce the radiation dose in children as much as possible without compromising the clinical diagnostic value of the image.
|
Received: 09 September 2019
|
|
|
|
|
[1] United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, effects and risks of ionizing radiation, annexe B. UNSCEAR 2013 Report to the general assembly with annexes[R]. New York: United Nations, 2013. [2] EACR general assembly[J]. EACR general assembly[J]. Eur J Cancer Suppl,2008,6(9) [3] Mettler F A Jr, Bhargavan M, Faulkner K, et al. Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources-1950—2007[J]. Radiology, 2009, 253(2): 520-531 [4] 郑钧正, 岳保荣, 李述唐, 等. 我国“九五”期间X射线诊断的医疗照射频率水平[J]. 中华放射医学与防护杂志,2001(S1):20-24 [5] 苏垠平. 部分地区X射线诊断照射频度调查及CT所致癌症风险的研究[D]. 北京: 中国疾病预防控制中心, 2014. [6] World Health Organization. Communicating radiation risks in paediatric imaging: information to support health care discussions about benefit and risk[R]. Switzerland, 2016. [7] United Nations Scientific Committee on the Effects of Atomic Radiation. Evalution of medical exposures to ionizing radiation. UNSCEAR 2018 Report to the general assembly with annexes[R]. New York: United Nations, 2018. [8] Brenner D J, Elliston C D. Estimated radiation risks potentially associated with full-body CT screening[J]. Radiology, 2004, 232(3): 735-738 [9] Miglioretti D L, Johnson E, Williams A, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk[J]. JAMA Pediatr, 2013, 167(8): 700-707 [10] Su Y P, Niu H W, Chen J B, et al. Radiation dose in the thyroid and the thyroid cancer risk attributable to CT scans for pediatric patients in one general hospital of China[J]. Int J Environ Res Public Health, 2014, 11(3): 2793-2803 [11] 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志,2012,4(4):297-299 [12] Pearce M S, Salotti J A, Little M P, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study[J]. Lancet, 2012, 380(9840): 499-505 [13] Mathews J D, Forsythe A V, Brady Z, et al. Cancer risk in 680, 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians[J]. BMJ, 2013, 346: f2360 [14] Huang W Y, Muo C H, Lin C Y, et al. Paediatric head CT scan and subsequent risk of malignancy and benign brain tumour: a nation-wide population-based cohort study[J]. Br J Cancer, 2014, 110(9): 2354-2360 [15] Journy N, Rehel J L, Ducou Le Pointe H, et al. Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France[J]. Br J Cancer, 2015, 112(1): 185-193 [16] Krille L, Dreger S, Schindel R, et al. Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study[J]. Radiat Environ Biophys, 2015, 54(1): 1-12 [17] Meulepas J M, Ronckers C M, Smets A M J B, et al. Radiation exposure from pediatric CT scans and subsequent cancer risk in the Netherlands[J]. J Natl Cancer Inst, 2019, 111(3): 256-263 [18] 王道庆, 戚元刚. 优化CT扫描方案, 降低患者辐射剂量[J]. 中国辐射卫生,2010,19(2):187-188 [19] Hobbs J B, Goldstein N, Lind K E, et al. Physician knowledge of radiation exposure and risk in medical imaging[J]. J Am Coll Radiol, 2018, 15(1 Pt A): 34-43 [20] Boutis K, Thomas K E. Radiation dose awareness and disclosure practice in paediatric emergency medicine: how far have we come?[J]. Br J Radiol, 2016, 89(1061): 20160022 [21] Armao D, Hartman T, Shea C M, et al. A toolkit for pediatric CT dose reduction in community hospitals[J]. J Am Coll Radiol, 2016, 13(11): 1337-1342 [22] 陈邦文, 杨爱春, 何海青. 重视CT检查中儿童的辐射防护[J]. 中国辐射卫生,2010,19(2):168-169 [23] 胡小素, 苏垠平, 孙全富. 儿童辐射效应及其医疗照射防护的进展[J]. 中国辐射卫生,2017,26(1):119-122
|
|
|
|