Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France
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BACKGROUND: Recent epidemiological results suggested an increase of cancer risk after receiving computed tomography (CT) scans in childhood or adolescence. Their interpretation is questioned due to the lack of information about the reasons for examination. Our objective was to estimate the cancer risk related to childhood CT scans, and examine how cancer-predisposing factors (PFs) affect assessment of the radiation-related risk. METHODS: The cohort included 67,274 children who had a first scan before the age of 10 years from 2000 to 2010 in 23 French departments. Cumulative X-rays doses were estimated from radiology protocols. Cancer incidence was retrieved through the national registry of childhood cancers; PF from discharge diagnoses. RESULTS: During a mean follow-up of 4 years, 27 cases of tumours of the central nervous system, 25 of leukaemia and 21 of lymphoma were diagnosed; 32% of them among children with PF. Specific patterns of CT exposures were observed according to PFs. Adjustment for PF reduced the excess risk estimates related to cumulative doses from CT scans. No significant excess risk was observed in relation to CT exposures. CONCLUSIONS: This study suggests that the indication for examinations, whether suspected cancer or PF management, should be considered to avoid overestimation of the cancer risks associated with CT scans.
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- Authors
- Journy, N., Rehel, J.-L., Ducou Le Pointe, H., Lee, C., Brisse, H., Chateil, J.-F., Caer-Lorho, S., Laurier, D., & Bernier, M.-O.
- Affiliations
- Institut de Radioprotection et de Sûreté Nucléaire (FR)
- National Institutes of Health (US)
- Institut Curie (FR)
- Hôpital Pellegrin (FR)
- Corresponding author
- Bernier, M-O
- Venue
- British Journal of Cancer
- Published
- 2014-10-14
- Volume
- 112
- Issue
- 1
- Pages
- 185-193
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC4647234
- OpenAlex
- W1502222060
- Cited by
- 202
- References
- 40
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 9 · 2023: 12 · 2022: 15 · 2021: 23 · 2020: 20 · 2019: 18 · 2018: 17 · 2017: 19 · 2016: 33 · 2015: 21 · 2013: 1
- FWCI
- 18.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- European Commission (269912)
- Centre Hospitalier Régional Universitaire de Montpellier
- Assistance publique-Hôpitaux de Paris
- 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
- radiation-induced cancer risk, confounding by indication, cumulative radiation dose, central nervous system tumors, pediatric leukemia, pediatric lymphoma, childhood cancer incidence
- MeSH terms
- Child, Child, Preschool, Female, France, Humans, Male, Neoplasms, Tomography, X-Ray Computed, Cohort Studies, Incidence, Risk Assessment
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