Hammer Gaël P, Seidenbusch Michael C, Schneider Karl, Regulla Dieter F, Zeeb Hajo, Spix Claudia, Blettner Maria
Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg-University, Mainz, Germany.
Radiat Res. 2009 Apr;171(4):504-12. doi: 10.1667/RR1575.1.
Ionizing radiation is an established cause of cancer, yet little is known about the health effects of doses from diagnostic examinations in children. The risk of childhood cancer was studied in a cohort of 92.957 children who had been examined with diagnostic X rays in a large German hospital during 1976-2003. Radiation doses were reconstructed using the individual dose area product and other exposure parameters, together with conversion coefficients developed specifically for the medical devices and standards used at the radiology department. Newly diagnosed cancers occurring between 1980 and 2006 were determined through record linkage to the German Childhood Cancer Registry. The median radiation dose was 7 microSv. Eight-seven incident cases were found in the cohort: 33 leukemia, 13 lymphoma, 10 central nervous system tumors, and 31 other tumors. The standardized incidence ratio (SIR) for all cancers was 0.99 (95% CI: 0.79-1.22). No trend in the incidence of total cancer, leukemia or solid tumors with increasing radiation dose was observed in the SIR analysis or in the multivariate Poisson regression. Risk did not differ significantly in girls and boys. Overall, while no increase in cancer risk with diagnostic radiation was observed, the results are compatible with a broad range of risk estimates.
电离辐射是已确定的致癌因素，但对于儿童诊断性检查所接受剂量的健康影响却知之甚少。对1976年至2003年期间在一家大型德国医院接受诊断性X射线检查的92957名儿童队列进行了儿童癌症风险研究。利用个体剂量面积乘积和其他暴露参数，以及专门为放射科所使用的医疗设备和标准制定的转换系数，重建了辐射剂量。通过与德国儿童癌症登记处的记录链接，确定了1980年至2006年期间新诊断出的癌症。中位辐射剂量为7微希沃特。该队列中发现了87例发病病例：33例白血病、13例淋巴瘤、10例中枢神经系统肿瘤和31例其他肿瘤。所有癌症的标准化发病比（SIR）为0.99（95%置信区间：0.79 - 1.22）。在SIR分析或多变量泊松回归中，未观察到总癌症、白血病或实体瘤发病率随辐射剂量增加的趋势。女孩和男孩的风险没有显著差异。总体而言，虽然未观察到诊断性辐射会增加癌症风险，但结果与广泛的风险估计值相符。
