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Cited by 39Radiation Dose and ImagingEffects of Radiation ExposureRadiology practices and education

Childhood cancer risks estimates following CT scans: an update of the French CT cohort study

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Foucault, Anaïs, Ancelet, Sophie, Dreuil, Serge, Caër-Lorho, Sylvaine, Ducou Le Pointe, Hubert, Brisse, Hervé, Chateil, Jean-François, Lee, Choonsik +2 more·2022·European Radiology
DOI 10.1007/s00330-022-08602-z
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Abstract

Objectives Increased risks of central nervous system (CNS) tumors and leukemia associated with computed tomography (CT) exposure during childhood have been reported in recent epidemiological studies. However, no evidence of increased risks was suggested in a previous analysis of the French CT cohort. This study benefits from an updated cohort with a longer follow-up and a larger sample size of patients.Methods The patients were followed from the date of their first CT (between 2000 and 2011) until their date of cohort exit defined as the earliest among the following: 31 December 2016, date of death, date of first cancer diagnosis or date of their 18 th birthday. Cancer incidence, vital status, cancer predisposing factors (PFs), and additional CT scans were collected via external national databases. Hazard ratios (HRs) associated to cumulative organ doses and sex were estimated from Cox models.Results At the end of follow-up, mean cumulative doses were 27.7 and 10.3 mGy for the brain and the red bone marrow (RBM), respectively. In patients without PFs, an HR per 10 mGy of 1.05 (95% CI: 1.01-1.09) for CNS tumors, 1.17 (95% CI: 1.09-1.26) for leukemia, and 0.96 (95% CI: 0.63-1.45) for lymphoma was estimated. These estimates were not modified by the inclusion of CT scans performed outside the participating hospitals or after the inclusion period.Conclusions This study shows statistically significant dose-response relationships for CNS tumors and leukemia for patients without PFs.Key points • Computed tomography is the most important contributor to the collective dose for diagnostic imaging to the French population. • Concerns have been raised about possible cancer risks, particularly after exposure to CT in childhood, due to the greater radiation sensitivity of children and to their longer life expectancy. • Analysis of the updated French CT cohort shows statistically significant dose-response relationships for CNS tumors and leukemia.

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  • Confounding by indication was evaluated either directly from medical records or indirectly through modeling in several national EPI-CT cohorts.

    “Confounding by indication was, however, evaluated either directly—from a review of medical records—or indirectly—through modeling—in several national EPI-CT cohorts15–17,33,34.”

    From Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults (2023) · cites this paper as [17]

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Authors
Foucault, A., Ancelet, S., Dreuil, S., Caër-Lorho, S., Ducou Le Pointe, H., Brisse, H., Chateil, J.-F., Lee, C., Leuraud, K., & Bernier, M.-O.
Affiliations
  • Institut de Radioprotection et de Sûreté Nucléaire (FR)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • Centre Hospitalier Universitaire de Bordeaux (FR)
  • National Institutes of Health (US)
Corresponding author
Foucault, Anaïs
ORCID
Venue
European Radiology
Publisher
Springer Science and Business Media LLC
Published
2022-03-01
Volume
32
Issue
8
Pages
5491-5498
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
DOI
10.1007/s00330-022-08602-z
OpenAlex
W4214710326
Cited by
39
References
27
Citations by year
2026: 3 · 2025: 12 · 2024: 5 · 2023: 14 · 2022: 5
FWCI
5.12
Type
journal article
Language
en
Open access
Licence
Locations
  • European Radiology (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Keywords
childhood cancer risk, computed tomography, ionizing radiation exposure, central nervous system tumors, leukemia, lymphoma, dose-response relationship
MeSH terms
Child, Humans, Leukemia, Neoplasms, Radiation-Induced, Radiation Dosage, Tomography, X-Ray Computed, Cohort Studies, Incidence, Central Nervous System Neoplasms

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