Cited by 186Radiation Dose and ImagingEffects of Radiation ExposureGlobal Cancer Incidence and Screening

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Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study

Krille, L., Dreger, S., Schindel, R., Albrecht, T., Asmussen, M., Barkhausen, J., Berthold, J. D., Chavan, A., Claussen, C., Forsting, M., Gianicolo, E. A. L., Jablonka, K., Jahnen, A., Langer, M., Laniado, M., Lotz, J., Mentzel, H. J., Queißer-Wahrendorf, A., Rompel, O., Schlick, I., Schneider, K., Schumacher, M., Seidenbusch, M., Spix, C., Spors, B., Staatz, G., Vogl, T., Wagner, J., Weisser, G., Zeeb, H., Blettner, M.·2015·Radiation and Environmental Biophysics

DOI 10.1007/s00411-014-0580-3

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Abstract

The aim of this cohort study was to assess the risk of developing cancer, specifically leukaemia, tumours of the central nervous system and lymphoma, before the age of 15 years in children previously exposed to computed tomography (CT) in Germany. Data for children with at least one CT between 1980 and 2010 were abstracted from 20 hospitals. Cancer cases occurring between 1980 and 2010 were identified by stochastic linkage with the German Childhood Cancer Registry (GCCR). For all cases and a sample of non-cases, radiology reports were reviewed to assess the underlying medical conditions at time of the CT. Cases were only included if diagnosis occurred at least 2 years after the first CT and no signs of cancer were recorded in the radiology reports. Standardised incidence ratios (SIR) using incidence rates from the general population were estimated. The cohort included information on 71,073 CT examinations in 44,584 children contributing 161,407 person-years at risk with 46 cases initially identified through linkage with the GCCR. Seven cases had to be excluded due to signs possibly suggestive of cancer at the time of first CT. Overall, more cancer cases were observed (O) than expected (E), but this was mainly driven by unexpected and possibly biased results for lymphomas. For leukaemia, the SIR (SIR = O/E) was 1.72 (95 % CI 0.89-3.01, O = 12), and for CNS tumours, the SIR was 1.35 (95 % CI 0.54-2.78, O = 7). Despite careful examination of the medical information, confounding by indication or reverse causation cannot be ruled out completely and may explain parts of the excess. Furthermore, the CT exposure may have been underestimated as only data from the participating clinics were available. This should be taken into account when interpreting risk estimates.

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Authors: Krille, L., Dreger, S., Schindel, R., Albrecht, T., Asmussen, M., Barkhausen, J., Berthold, J. D., Chavan, A., Claussen, C., Forsting, M., Gianicolo, E. A. L., Jablonka, K., Jahnen, A., Langer, M., Laniado, M., Lotz, J., Mentzel, H. J., Queißer-Wahrendorf, A., Rompel, O., Schlick, I., Schneider, K., Schumacher, M., Seidenbusch, M., Spix, C., Spors, B., Staatz, G., Vogl, T., Wagner, J., Weisser, G., Zeeb, H., & Blettner, M.
Affiliations: University Medical Center of the Johannes Gutenberg University Mainz (DE)
University of Bremen (DE)
Vivantes Klinikum (DE)
Städtisches Klinikum Karlsruhe (DE)
University Hospital Schleswig-Holstein (DE)
Medizinische Hochschule Hannover (DE)
Klinikum Oldenburg (DE)
Universitätsklinikum Tübingen (DE)
Essen University Hospital (DE)
Klinikum Bremen-Mitte (DE)
Centre de recherche public Henri-Tudor (LU)
University Medical Center Freiburg (DE)
University Hospital Carl Gustav Carus (DE)
Universitätsmedizin Göttingen (DE)
Jena University Hospital (DE)
Johannes Gutenberg University Mainz (DE)
Universitätsklinikum Erlangen (DE)
Nuremberg Hospital (DE)
LMU Klinikum (DE)
University of Freiburg (DE)
Charité – Universitätsmedizin Berlin (DE)
Goethe University Frankfurt (DE)
Klinikum im Friedrichshain (DE)
University Medical Centre Mannheim (DE)
Corresponding author: Blettner, M.
ORCID: Dreger, S.
Albrecht, T.
Barkhausen, J.
Claussen, C.
Forsting, M.
Gianicolo, E. A. L.
Jahnen, A.
Langer, M.
Lotz, J.
Mentzel, H. J.
Rompel, O.
Schneider, K.
Schumacher, M.
Seidenbusch, M.
Spix, C.
Staatz, G.
Vogl, T.
Zeeb, H.
Blettner, M.
Venue: Radiation and Environmental Biophysics
Publisher: Springer Science and Business Media LLC
Published: 2015-01-08
Volume: 54
Issue: 1
Pages: 1-12
ISSN: 0301-634X (ISSN-L)
1432-2099
DOI: 10.1007/s00411-014-0580-3
OpenAlex: W4252769413
Cited by: 184
References: 29
Citations by year: 2026: 8 · 2025: 8 · 2024: 12 · 2023: 13 · 2022: 16 · 2021: 21 · 2020: 16 · 2019: 16 · 2018: 22 · 2017: 14 · 2016: 27 · 2015: 10
FWCI: 19.69
Type: journal article
Language: en
Update notices: correction (2017-06-13)
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Radiation and Environmental Biophysics (publishedVersion)
PubMed (publishedVersion)
GRO (submittedVersion)
Funders: World Health Organization
Bundesministerium für Bildung und Forschung
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 › Oncology › Global Cancer Incidence and Screening
Keywords: childhood cancer, computed tomography, ionizing radiation exposure, leukemia, central nervous system tumors, lymphoma, cancer incidence, confounding by indication, reverse causality, radiation-induced cancer risk, German Childhood Cancer Registry
MeSH terms: Adolescent, Child, Child, Preschool, Female, Germany, Humans, Infant, Infant, Newborn, Male, Neoplasms, Radiation-Induced, Radiation, Ionizing, Risk, Tomography, X-Ray Computed, Cohort Studies, Incidence

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Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study

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