Computed tomographies and cancer risk in children: a literature overview of CT practices,risk estimations and an epidemiologic cohort study proposal |
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Authors: | Lucian Krille Hajo Zeeb Andreas Jahnen Peter Mildenberger Michael Seidenbusch Karl Schneider Gerald Weisser Gael Hammer Peter Scholz Maria Blettner |
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Institution: | 1.Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI),Universit?tsmedizin der Johannes Gutenberg-Universit?t Mainz,Mainz,Germany;2.Diagnostische und Interventionelle Radiologie,Universit?tsmedizin der Johannes Gutenberg-Universit?t Mainz,Mainz,Germany;3.Institut für Epidemiologie und Pr?ventionsforschung GmbH (BIPS),Bremen,Germany;4.Centre de Recherche Public Henri Tudor,Luxembourg,Germany;5.Dr. von Haunersches Kinderspital,Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universit?t München,München,Germany;6.Institut für Klinische Radiologie und Nuklearmedizin,Universit?tsklinikum Mannheim,Mannheim,Germany |
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Abstract: | Radiation protection is a topic of great public concern and of many scientific investigations, because ionizing radiation
is an established risk factor for leukaemia and many solid tumours. Exposure of the public to ionizing radiation includes
exposure to background radiation, as well as medical and occupational exposures. A large fraction of the exposure from diagnostic
procedures comes from medical imaging. Computed tomography (CT) is the major single contributor of diagnostic radiation exposure.
An increase in the use of CTs has been reported over the last decades in many countries. Children have smaller bodies and
lower shielding capacities, factors that affect the individual organ doses due to medical imaging. Several risk models have
been applied to estimate the cancer burden caused by ionizing radiation from CT. All models predict higher risks for cancer
among children exposed to CT as compared to adults. However, the cancer risk associated with CT has not been assessed directly
in epidemiological studies. Here, plans are described to conduct an historical cohort study to investigate the cancer incidence
in paediatric patients exposed to CT before the age of 15 in Germany. Patients will be recruited from radiology departments
of several hospitals. Their individual exposure will be recorded, and time-dependent cumulative organ doses will be calculated.
Follow-up for cancer incidence via the German Childhood Cancer Registry will allow computation of standardized incidence ratios
using population-based incidence rates for childhood cancer. Dose–response modelling and analyses for subgroups of children
based on the indication for and the result of the CT will be performed. |
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