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Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT
Abstract
OBJECTIVE: In light of the rapidly increasing frequency of pediatric CT examinations, the purpose of our study was to assess the lifetime cancer mortality risks attributable to radiation from pediatric CT. MATERIALS AND METHODS: Organ doses as a function of age-at-diagnosis were estimated for common CT examinations, and estimated attributable lifetime cancer mortality risks (per unit dose) for different organ sites were applied. Standard models that assume a linear extrapolation of risks from intermediate to low doses were applied. On the basis of current standard practice, the same exposures (milliampere-seconds) were assumed, independent of age. RESULTS: The larger doses and increased lifetime radiation risks in children produce a sharp increase, relative to adults, in estimated risk from CT. Estimated lifetime cancer mortality risks attributable to the radiation exposure from a CT in a 1-year-old are 0.18% (abdominal) and 0.07% (head)-an order of magnitude higher than for adults-although those figures still represent a small increase in cancer mortality over the natrual background rate. In the United States, of approximately 600,000 abdominal and head CT examinations annually performed in children under the age of 15 years, a rough estimate is that 500 of these individuals might ultimately die from cancer attributable to the CT radiation. CONCLUSION: The best available risk estimates suggest that pediatric CT will result in significantly increased lifetime radiation risk over adult CT, both because of the increased dose per milliampere-second, and the increased lifetime risk per unit dose. Lower milliampere-second settings can be used for children without significant loss of information. Although the risk-benefit balance is still strongly tilted toward benefit, because the frequency of pediatric CT examinations is rapidly increasing, estimates that quantitative lifetime radiation risks for children undergoing CT are not negligible may stimulate more active reduction of CT exposure settings in pediatric patients.
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“Brenner et al. concluded already in 2001 that paediatric CT scans significantly increase the lifetime risk of cancer mortality due to the higher radiation sensitivity of children”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [66]
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Metadata
- Authors
- Brenner, D. J., Elliston, C. D., Hall, E. J., & Berdon, W. E.
- Affiliations
- Columbia University (US)
- Columbia University Irving Medical Center (US)
- Venue
- American Journal of Roentgenology
- Publisher
- American Roentgen Ray Society
- Published
- 2001-02
- Volume
- 176
- Issue
- 2
- Pages
- 289-296
- ISSN
- 0002-9580 (ISSN-L)
- 0361-803X
- 1546-3141
- OpenAlex
- W2138025351
- Cited by
- 3,222
- References
- 79
- Citations by year
- 2026: 44 · 2025: 92 · 2024: 78 · 2023: 115 · 2022: 116 · 2021: 134 · 2020: 148 · 2019: 137 · 2018: 124 · 2017: 141 · 2016: 190 · 2015: 186 · 2014: 179 · 2013: 176 · 2012: 213
- FWCI
- 60.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Roentgenology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ca077285-03)
- National Cancer Institute (CA77285)
- 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
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- pediatric computed tomography, radiation-induced cancer, age at diagnosis, linear no-threshold model, low-dose radiation risk, abdominal CT, head CT, benefits and risks
- MeSH terms
- Adolescent, Cause of Death, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Neoplasms, Radiation-Induced, Tomography, X-Ray Computed, Risk Assessment
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