The DOI matches its Crossref record; 40 of the 41 references it cites were found in a registry or an index.
Leukaemia and myeloid malignancy among people exposed to low doses (<100 mSv) of ionising radiation during childhood: a pooled analysis of nine historical cohort studies
Open accessAbstract
Background Substantial evidence links exposure to moderate or high doses of ionising radiation, particularly in childhood, with increased risk of leukaemia. The association of leukaemia with exposure to low-dose (<100 mSv) radiation is less certain, although this is the dose range most relevant to the general population. We aimed to estimate the risk of leukaemia associated with low-dose radiation exposure in childhood (age <21 years).Methods In this analysis of historical cohort studies, we pooled eligible cohorts reported up to June 30, 2014. We evaluated leukaemia and myeloid malignancy outcomes in these cohorts with the relevant International Classification of Diseases and International Classification of Diseases for Oncology definitions. The cohorts included had not been treated for malignant disease, had reported at least five cases of the relevant haematopoietic neoplasms, and estimated individual active bone marrow (ABM) doses. We restricted analysis to individuals who were younger than 21 years at first irradiation who had mean cumulative ABM doses of less than 100 mSv. Dose-response models were fitted by use of Poisson regression. The data were received in fully anonymised form by the statistical analyst.Findings We identified nine eligible cohorts from Canada, France, Japan, Sweden, the UK, and the USA, including 262 573 people who had been exposed to less than 100 mSv enrolled between June 4, 1915, and Dec 31, 2004. Mean follow-up was 19·63 years (SD 17·75) and mean cumulative ABM dose was 19·6 mSv (SD 22·7). 154 myeloid malignancies were identified (which included 79 acute myeloid leukaemias, eight myelodysplastic syndromes, and 36 chronic myeloid leukaemias, in addition to other unspecified myeloid malignancies) and 40 acute lymphoblastic leukaemias, with 221 leukaemias (including otherwise unclassified leukaemias but excluding chronic lymphocytic leukaemia) identified overall. The fitted relative risks at 100 mSv were 3·09 (95% CI 1·41-5·92; p trend=0·008) for acute myeloid leukaemia and myelodysplastic syndromes combined, 2·56 (1·09-5·06; p trend=0·033) for acute myeloid leukaemia, and 5·66 (1·35-19·71; p trend=0·023) for acute lymphoblastic leukaemia. There was no clear dose-response for chronic myeloid leukaemia, which had a relative risk at 100 mSv of 0·36 (0·00-2·36; p trend=0·394). There were few indications of between-cohort heterogeneity or departure from linearity. For acute myeloid leukaemia and myelodysplastic syndromes combined and for acute lymphoblastic leukaemia, the dose-responses remained significant for doses of less than 50 mSv. Excess absolute risks at 100 mSv were in the range of 0·1-0·4 cases or deaths per 10 000 person-years.Interpretation The risks of acute myeloid leukaemia and acute lymphoblastic leukaemia were significantly increased after cumulative doses of ionising radiation of less than 100 mSv in childhood or adolescence, with an excess risk also apparent for cumulative radiation doses of less than 50 mSv for some endpoints. These findings support an increased risk of leukaemia associated with low-dose exposure to radiation and imply that the current system of radiological protection is prudent and not overly protective.Funding National Cancer Institute Intramural Research Program, National Cancer Institute, and US National Institutes for Health.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Indeed, our leukemia risk estimate is compatible with those derived in a recent combined analysis of data on individuals exposed before the age of 21 years and ABM dose <100 mGy (ERR/100 mGy 0.84–4.66, depending on leukemia subtype)38.”
From Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults (2023) · cites this paper as [38]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
(2005) · Springer eBooks · doi:10.1007/0-387-27255-0_9 · Cited by 20,333
Brown, R. A., Hastie, T. J., & Tibshirani, R. J. (1991) · Biometrics · doi:10.2307/2532174 · Cited by 8,263
Koyak, R. A., Hastie, T. J., & Tibshirani, R. J. (1991) · Journal of the American Statistical Association · doi:10.2307/2290538 · Cited by 7,717
Recommendations of the International Commission on Radiological Protection
(1961) · Postgraduate Medical Journal · doi:10.1136/pgmj.37.425.168-b · Cited by 5,868
Hossfeld, D. K. (2002) · Annals of Oncology · doi:10.1093/annonc/mdf146 · Cited by 4,614
Pearce, M. S., Salotti, J. A., Little, M. P., McHugh, K., Lee, C., Kim, K. P., Howe, N. L., Ronckers, C. M., Rajaraman, P., Craft, A. W., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60815-0 · Cited by 3,735
Self-citationPreface, Executive Summary and Glossary
(2007) · Annals of the ICRP · doi:10.1016/j.icrp.2007.10.003 · Cited by 2,116
Recommendations of the International Commission on Radiological Protection, ICRP Publication 26
Icrp (1977) · Medical Entomology and Zoology · Cited by 1,785
Measurement error in nonlinear models: a modern perspective
Carroll, R. J. (2006) · Cited by 1,374
Benefits and costs, an eternal balance
Dixon, A. K. (2007) · Annals of the ICRP · doi:10.1016/j.icrp.2007.09.001 · Cited by 1,355
Cited by
Sorted by citations
Items 101–152 of 152
de González, A. B., Sawyer, I., & Veiga, L. H. S. (2025) · Carcinogenesis · doi:10.1093/carcin/bgaf058 · Cited by 4
Becking, B. E., Fledderus, A. C., van Merkesteyn, J. P. R., & Jonkman, R. E. G. (2023) · European Journal of Orthodontics · doi:10.1093/ejo/cjad019 · Cited by 4
Frush, D. P., Ansari, A. J., Brink, J. A., Kosti, O., Larson, D. B., Linet, M. S., Mahesh, M., Sechopoulos, I., & Vassileva, J. (2025) · Journal of Applied Clinical Medical Physics · doi:10.1002/acm2.70022 · Cited by 4
Self-citationCaution warranted for low-dose radiation therapy for Covid-19
Das, I. J., Kalapurakal, J. A., & Mittal, B. B. (2020) · British Journal of Radiology · doi:10.1259/bjr.20200466 · Cited by 4
Delniotis, I., Bontinis, V., Ktenidis, K., Drakonaki, E. E., & Galanis, N. (2024) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-024-02451-9 · Cited by 5
Use of the Linear No-threshold (LNT) Model in Radiological Protection: An Update
Laurier, D., Billarand, Y., Klokov, D. Y., & Tichauer, M. (2025) · Health Physics · doi:10.1097/hp.0000000000002063 · Cited by 3
DNA Damage Induced by Radiation Exposure from Cardiac Catheterization
Jin, Y., Yaegashi, D., Shi, L., Ishida, M., Sakai, C., Yokokawa, T., Abe, Y., Sakai, A., Yamaki, T., Kunii, H., et al. (2022) · International Heart Journal · doi:10.1536/ihj.22-037 · Cited by 3
Leukaemia risk associated with low-dose radiation
Hourigan, C. S., & Savani, B. N. (2018) · The Lancet Haematology · doi:10.1016/s2352-3026(18)30106-6 · Cited by 3
Cumulative radiation doses due to nuclear medicine examinations: a systematic review
Brambilla, M., Kuchcińska, A., Matheoud, R., & Muni, A. (2021) · British Journal of Radiology · doi:10.1259/bjr.20210444 · Cited by 3
Martín, C. F., Farto, J. C. A., Fernández, I. G., Ruiz, C. G., Barriuso, M. Á. L., Domene, M. M., Rincón, J. O., Rodríguez, M. J. P., Berenguer, L. R., Díaz, F. S., et al. (2024) · Radiation Physics and Chemistry · doi:10.1016/j.radphyschem.2024.111927 · Cited by 2
Beyond the Burn: Leukemia Threats Following Radioactive Iodine Ablation Therapy for Thyroid Cancer
Hussein, M. H., Toraih, E. A., Jishu, J. A., Lavorgna, T. R., Abdelmaksoud, A., Craig, R., & Kandil, E. H. (2024) · Cancers · doi:10.3390/cancers17010025 · Cited by 2
Little, M. P., Hamada, N., & Zablotska, L. B. (2025) · International Journal of Radiation Biology · doi:10.1080/09553002.2025.2544743 · Cited by 2
Self-citationMoreno, S. G., Ferri, F., Lewandowski, D., Barroca, V., Devanand, S., Déchamps, N., Roméo, P., & Nathalie, G. (2026) · iScience · doi:10.1016/j.isci.2026.114738 · Cited by 2
Odoh, C. M., Garba, N. N., Nasiru, R., Isma’il, M., & Onudibia, M. E. (2026) · Discover Environment · doi:10.1007/s44274-026-00836-8 · Cited by 2
Facteurs de risques environnementaux et professionnels de syndrome myélodysplasique
Garnier, R. (2023) · Bulletin du Cancer · doi:10.1016/j.bulcan.2023.02.024 · Cited by 2
Lina, X. U., & Song, J. (2022) · Food Science and Technology · doi:10.1590/fst.09422 · Cited by 2
Point-of-Care Ultrasound Versus X-ray for Pediatric Upper Extremity Injuries
Delniotis, I., Bontinis, V., Delniotis, A., Bontinis, A., Drakonaki, E. E., Ktenidis, K., & Galanis, N. (2025) · Pediatric Emergency Care · doi:10.1097/pec.0000000000003446 · Cited by 1
Wuermeling, Q. J., Ziegler, C., König, S., Göttling, L., Simon, D., Goller, S. S., Zvereva, A. V., Schroeder, A. S., Sitzberger, A., Berger, N., et al. (2025) · International Orthopaedics · doi:10.1007/s00264-025-06701-2 · Cited by 1
Investigating the causes of childhood acute lymphoblastic leukemia through mutational epidemiology
de Smith, A. J., Zhou, N., Li, Y., Liu, T., Patrus, N., & Wiemels, J. L. (2025) · Current problems in pediatric and adolescent health care · doi:10.1016/j.cppeds.2025.101818 · Cited by 2
Chadli, K., Ousli, H., Neani, H., Zaoui, F., Bouziane, A., & Benyahia, H. (2026) · BMC Oral Health · doi:10.1186/s12903-026-08522-0 · Cited by 2
Nassiri, M. A., Moghadam, N., Painchaud-Bouchard, A.-S., Hadouch, I., & Rehani, M. (2026) · Journal of medical imaging and radiation sciences · doi:10.1016/j.jmir.2026.102596 · Cited by 1
Science and Values in Radiological Protection
Glines, W. M. (2020) · Health Physics · doi:10.1097/hp.0000000000001192 · Cited by 1
Three-dimensional printed titanium pseudo-prosthesis for the treatment of a tumoral bone defect
Garceso, D. M., González-Quevedo, D., de Quevedo, D. G., & Tamimi, I. (2021) · JSES Reviews Reports and Techniques · doi:10.1016/j.xrrt.2021.09.002 · Cited by 1
Weng, W., & Chen, Y. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1654551 · Cited by 1
Yoshitake, T., Ono, K., Ishiguchi, T., Maeda, T., & Kai, M. (2020) · Radiation and Environmental Biophysics · doi:10.1007/s00411-020-00857-8 · Cited by 1
Kalinkin, D. E., Ab, K., Maksimov, D. E., Кириакиди, Е. Н., & Манихович, Т. Р. (2020) · Siberian Journal of Oncology · doi:10.21294/1814-4861-2020-19-6-7-18 · Cited by 1
Hafner, L., & Walsh, L. (2021) · Journal of Radiological Protection · doi:10.1088/1361-6498/ac290a · Cited by 1
Schabl, L., Küppers, J., Jhala, T., Winiker, H., Esslinger, P., & Lehner, M. (2022) · Children · doi:10.3390/children9071062 · Cited by 1
Konstantinoudis, G., Schuhmacher, D., Ammann, R. A., Diesch, T., Kuehni, C. E., Spycher, B. D., & for the Swiss Paediatric Oncology Group and the Swiss National Cohort Study Group (2019) · medRxiv · doi:10.1101/19001545 · Cited by 1
Cancer Incidence and Mortality in the U.S. Astronaut Corps, 1959-2017Preprint
Reynolds, R. J., Little, M. P., Day, S. M., Charvat, J. M., Blattnig, S. R., Huff, J. L., & Patel, Z. S. (2020) · doi:10.21203/rs.3.rs-55517/v1 · Cited by 1
Self-citationErdman, L., Rickard, M., Skreta, M., Sheth, K. R., Alvarez, D., Velaer, K. N., Chua, M. E., Santos, J. D., Keefe, D. T., Rosenblum, N. D., et al. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3967037 · Cited by 1
Konstantinoudis, G., Schuhmacher, D., Ammann, R. A., Diesch, T., Kuehni, C. E., & Spycher, B. D. (2020) · Research Square · doi:10.21203/rs.2.21872/v1 · Cited by 1
Squillaro, T., Finicelli, M., Peluso, G., & Galderisi, U. (2018) · Stem Cells · doi:10.1002/stem.2900
Jang, M., Han, E.-A., Shin, H. B., & Lee, Y. K. (2019) · Annals of Laboratory Medicine · doi:10.3343/alm.2019.39.4.419
CT in Crohn’s Disease Is Beneficial for Patient Care and Should Not Be Feared
Waszczuk, Ł., Waszczuk, K., & Waszczuk, E. (2019) · Digestive Diseases and Sciences · doi:10.1007/s10620-019-05678-4
Baqays, A. (2020) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r3-q0aw-rd08
Esposizioni radiodiagnostiche in età evolutiva
Corbella, D., Tinelli, D., & Righini, A. (2022) · Medico e Bambino · doi:10.53126/meb41161
Estimating the Risk of Radiation-Induced Malignancy Following Radiotherapy for Benign Disease
Nakamura, J. L., Braunstein, S. E., & McKEOWN, S. R. (2022) · Medical radiology · doi:10.1007/174_2022_349
Little, M. P., Hamada, N., & Zablotska, L. B. (2023) · Research Square · doi:10.21203/rs.3.rs-3700052/v1
Self-citationWollschläger, D. (2024) · Journal of Radiological Protection · doi:10.1088/1361-6498/ad1fe2
Wagner, F., König, S., Wuermeling, Q. J., Sitzberger, A., Paolini, M., Weigert, A., Lauseker, M., Endres, F., Schneller, J., Hubertus, J., et al. (2024) · International Orthopaedics · doi:10.1007/s00264-024-06184-7
Cronin, B. J., & Lee, J. C. (2024) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000010780
Nuclear Medicine in the Diagnosis and Management of Thyroid Nodules and Cancer
Nguyen, N. C., Chekuri, S., & Öz, O. K. (2024) · Springer eBooks · doi:10.1007/978-3-031-65288-2_6
Liubarets, T. F. (2024) · Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology · doi:10.33145/2304-8336-2024-29-67-78
Tao, S., Tao, H., Liu, Y., Wang, S., Li, M., Wang, J., Lü, G., Zhang, L. J., & Gu, H. (2025) · International Journal of Radiation Biology · doi:10.1080/09553002.2025.2591790
Konstantinoudis, G., Schuhmacher, D., Ammann, R. A., Diesch, T., Kuehni, C. E., & Spycher, B. D. (2020) · Figshare · doi:10.6084/m9.figshare.12151053
Liubarets, T. F. (2025) · Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology · doi:10.33145/2304-8336-2025-30-69-87
Wei, Y., Li, L., Li, Y., Wang, Q., Gong, Y., Wei, S., Yi, F., Guo, C., Wu, W., Yu, Y., et al. (2026) · Strahlentherapie und Onkologie · doi:10.1007/s00066-026-02517-0
Global Distribution of Natural Gamma Radiation Dose
Jindal, M. K. (2026) · Earth and environmental sciences library · doi:10.1007/978-3-032-18404-7_6
Gomot, M., Klokov, D., & Varès, G. (2026) · Biochimica et Biophysica Acta (BBA) - Reviews on Cancer · doi:10.1016/j.bbcan.2026.189607
Impact of shielding, time, and distance in radiation protection: systematic review
Messele, H. M., & Dagne, Y. (2026) · Journal of Radioanalytical and Nuclear Chemistry · doi:10.1007/s10967-026-11145-y
Metadata
- Authors
- Little, M. P., Wakeford, R., Borrego, D., French, B., Zablotska, L. B., Adams, M. J., Allodji, R., de Vathaire, F., Lee, C., Brenner, A. V., Miller, J. S., Campbell, D., Pearce, M. S., Doody, M. M., Holmberg, E., Lundell, M., Sadetzki, S., Linet, M. S., & Berrington de González, A.
- Affiliations
- National Institutes of Health (US)
- University of Manchester (GB)
- National Cancer Institute (US)
- Radiation Effects Research Foundation (JP)
- University of California, San Francisco (US)
- University of Rochester Medicine (US)
- Inserm (FR)
- Information Management Services (US)
- National Institute for Health and Care Research (GB)
- Sahlgrenska University Hospital (SE)
- Karolinska University Hospital (SE)
- Tel Aviv University (IL)
- Corresponding author
- Little, Mark P
- ORCID
- Venue
- The Lancet Haematology
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 5
- Issue
- 8
- Pages
- e346-e358
- ISSN
- 2352-3026 (ISSN-L)
- PMC
- PMC6130888
- OpenAlex
- W2883741998
- Cited by
- 152
- References
- 41
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 23 · 2023: 17 · 2022: 23 · 2021: 30 · 2020: 21 · 2019: 13 · 2018: 3
- FWCI
- 11.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet Haematology (acceptedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity) (cc-by-nc-nd)
- Funders
- National Academy of Sciences
- Foundation for the National Institutes of Health (R01CA197422, R03CA188614)
- Division of Cancer Epidemiology and Genetics, National Cancer Institute
- Ministry of Health, Labour and Welfare
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Physical Sciences › Physics and Astronomy › Radiation › Radioactivity and Radon Measurements
- Keywords
- pediatric radiation exposure, low-dose radiation, leukemia, myeloid neoplasms, acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia, myelodysplastic syndrome, dose-response relationship, radiation-induced cancer risk, historical cohort study, pooled analysis
- MeSH terms
- Adult, Aged, Child, Female, Humans, Leukemia, Male, Middle Aged, Neoplasms, Radiation-Induced, Radiation Dosage, Risk, Cohort Studies, Bone Marrow Neoplasms, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
