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Article Dans Une Revue Nature Medicine Année : 2023

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

1 ISGlobal - Instituto de Salud Global - Institute For Global Health [Barcelona]
2 UPF - Universitat Pompeu Fabra [Barcelona]
3 Spanish Consortium for Research on Epidemiology and Public Health
4 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
5 Newcastle University
6 Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane
7 IARC - International Agency for Research on Cancer
8 IRSN/PSE-SANTE/SESANE/LEPID - Laboratoire d épidémiologie des rayonnements ionisants
9 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
10 Institute of Medical Biostatistics, Epidemiology and Informatics
11 SCK-CEN - Centre d'Etude de l'Energie Nucléaire
12 Norwegian Radiation and Nuclear Safety Authority
13 LIST - Luxembourg Institute of Science and Technology
14 NCI-NIH - National Cancer Institute [Bethesda]
15 Division of Cancer Epidemiology and Genetics
16 CAATS - Centre d'Assurance qualité des Applications Technologiques dans le domaine de la Santé
17 SCK-CEN - Belgian Nuclear Research Centre [Mol, Belgique]
18 Danish Cancer Society Research Center
19 University of Mainz
20 Karolinska University Hospital [Stockholm]
21 Cancer Registry of Norway
22 CESP - Centre de recherche en épidémiologie et santé des populations
23 The Netherlands Cancer Institute [Amsterdam, The Netherlands]
24 International Agency for Research on Cancer [Lyon, France]
25 Department of Clinical Neuroscience, Division of Neurology
26 University Medical Center, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)
27 CIRC - Centre international de Recherche sur le Cancer
28 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
Jérémie Dabin

Résumé

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.
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irsn-04399853 , version 1 (17-01-2024)

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Magda Bosch de Basea Gomez, Isabelle Thierry-Chef, Richard Harbron, Michael Hauptmann, Graham Byrnes, et al.. Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults. Nature Medicine, 2023, 29 (12), pp.3111-3119. ⟨10.1038/s41591-023-02620-0⟩. ⟨irsn-04399853⟩
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