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成像技术会引发癌症吗?驳斥辐射致癌的线性无阈模型。

Does Imaging Technology Cause Cancer? Debunking the Linear No-Threshold Model of Radiation Carcinogenesis.

作者信息

Siegel Jeffry A, Welsh James S

机构信息

Nuclear Physics Enterprises, Marlton, NJ, USA.

Department of Radiation Oncology, Stritch School of Medicine Loyola University-Chicago, Maywood, IL, USA

出版信息

Technol Cancer Res Treat. 2016 Apr;15(2):249-56. doi: 10.1177/1533034615578011. Epub 2015 Mar 30.

Abstract

In the past several years, there has been a great deal of attention from the popular media focusing on the alleged carcinogenicity of low-dose radiation exposures received by patients undergoing medical imaging studies such as X-rays, computed tomography scans, and nuclear medicine scintigraphy. The media has based its reporting on the plethora of articles published in the scientific literature that claim that there is "no safe dose" of ionizing radiation, while essentially ignoring all the literature demonstrating the opposite point of view. But this reported "scientific" literature in turn bases its estimates of cancer induction on the linear no-threshold hypothesis of radiation carcinogenesis. The use of the linear no-threshold model has yielded hundreds of articles, all of which predict a definite carcinogenic effect of any dose of radiation, regardless of how small. Therefore, hospitals and professional societies have begun campaigns and policies aiming to reduce the use of certain medical imaging studies based on perceived risk:benefit ratio assumptions. However, as they are essentially all based on the linear no-threshold model of radiation carcinogenesis, the risk:benefit ratio models used to calculate the hazards of radiological imaging studies may be grossly inaccurate if the linear no-threshold hypothesis is wrong. Here, we review the myriad inadequacies of the linear no-threshold model and cast doubt on the various studies based on this overly simplistic model.

摘要

在过去几年中,大众媒体给予了大量关注,聚焦于接受X射线、计算机断层扫描和核医学闪烁扫描等医学成像检查的患者所受到的低剂量辐射暴露的所谓致癌性。媒体的报道基于科学文献中大量声称电离辐射“没有安全剂量”的文章,而基本上忽略了所有表明相反观点的文献。但这些报道的“科学”文献反过来又基于辐射致癌的线性无阈假说来估计癌症诱发情况。线性无阈模型的使用产生了数百篇文章,所有这些文章都预测任何剂量的辐射都有明确的致癌作用,无论剂量有多小。因此,医院和专业协会已开始开展活动并制定政策,旨在基于感知到的风险效益比假设减少某些医学成像检查的使用。然而,由于它们基本上都基于辐射致癌的线性无阈模型,如果线性无阈假说是错误的,那么用于计算放射成像检查危害的风险效益比模型可能会严重不准确。在此,我们回顾线性无阈模型的众多不足之处,并对基于这个过于简单化模型的各种研究提出质疑。

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