Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries
Abstract
Background Diagnostic X-rays are the largest man-made source of radiation exposure to the general population, contributing about 14% of the total annual exposure worldwide from all sources. Although diagnostic X-rays provide great benefits, that their use involves some small risk of developing cancer is generally accepted. Our aim was to estimate the extent of this risk on the basis of the annual number of diagnostic X-rays undertaken in the UK and in 14 other developed countries.Methods We combined data on the frequency of diagnostic X-ray use, estimated radiation doses from X-rays to individual body organs, and risk models, based mainly on the Japanese atomic bomb survivors, with population-based cancer incidence rates and mortality rates for all causes of death, using life table methods.Findings Our results indicate that in the UK about 0.6% of the cumulative risk of cancer to age 75 years could be attributable to diagnostic X-rays. This percentage is equivalent to about 700 cases of cancer per year. In 13 other developed countries, estimates of the attributable risk ranged from 0.6% to 1.8%, whereas in Japan, which had the highest estimated annual exposure frequency in the world, it was more than 3%.Interpretation We provide detailed estimates of the cancer risk from diagnostic X-rays. The calculations involved a number of assumptions and so are inevitably subject to considerable uncertainty. The possibility that we have overestimated the risks cannot be ruled out, but that we have underestimated them substantially seems unlikely.
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There is an estimated risk of cancer attributed to the use of diagnostic X-rays due to the stochastic effects of the X-rays.
“There is an estimated risk of cancer which is attributed to the use of diagnostic X-rays due to the stochastic effects of the X-rays [3, 4].”
From Adult Computed Tomography examinations in Uganda: Towards determining the National Diagnostic Reference Levels (2022) · cites this paper as [3]
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- Authors
- de González, A. B., & Darby, S.
- Affiliations
- University of Oxford (GB)
- ORCID
- Darby, Sarah
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2004-01
- Volume
- 363
- Issue
- 9406
- Pages
- 345-351
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2110496314
- Cited by
- 1,718
- References
- 29
- Citations by year
- 2026: 27 · 2025: 60 · 2024: 48 · 2023: 59 · 2022: 61 · 2021: 61 · 2020: 84 · 2019: 92 · 2018: 72 · 2017: 73 · 2016: 99 · 2015: 79 · 2014: 106 · 2013: 99 · 2012: 96
- FWCI
- 72.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- 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 › Health Professions › Radiological and Ultrasound Technology › Radioactivity and Radon Measurements
- Keywords
- diagnostic X-rays, cancer risk, radiation-induced cancer, radiation dose, attributable risk, cancer incidence, cancer mortality, life table method, Japanese atomic bomb survivors, developed countries
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, United Kingdom, Humans, Infant, Japan, Leukemia, Radiation-Induced, Male, Middle Aged, Neoplasms, Radiation-Induced, Radiation Dosage, Radiography, Risk Factors, Tomography, X-Ray Computed, X-Rays, Models, Statistical
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