Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea.
Department of Social Medicine, School of Medicine, Sungkyunkwan University, Suwon, Korea.
J Korean Med Sci. 2018 Jun 21;33(29):e211. doi: 10.3346/jkms.2018.33.e211. eCollection 2018 Jul 16.
Radiation exposure from medical procedures has been rapidly increasing. We purposed to estimate the fraction of cancer incidence and mortality attributed to diagnostic medical radiation exposure in Korea.
Using information on diagnostic medical radiation exposure from various sources including national health examination (National Health Insurance Service), private health examination, and conscription health examination; the annual mean exposed organ dose (mGy) from all diagnostic medical radiation use, grouped by sex and 5-year age ranges up to 80 years, was calculated. Cancer incidence and mortality lifetime attributable risks (LARs) up to 85 years using estimated exposed organ doses and biological effects of ionizing radiation (BEIR) VII model (excess relative risk and excess absolute risk) were estimated. Using background cancer incidence and mortality risk based on the national database, along with estimated LARs, we finally estimated population attributable fraction (PAF) of cancer incidence and mortality.
The PAF for diagnostic medical radiation exposure among all cancers of Koreans was 0.9% for incidence and mortality, resulting 1,915 cancer cases and 637 cancer deaths a year. The PAF in females was higher than those in males: 1.2% and 1.7% (incidence and mortality) versus 0.6% (same in incidence and mortality), respectively.
The estimated PAF for diagnostic medical radiation in Korea in 2013 was higher than those reported in the UK in 2004. Optimized management of diagnostic medical radiation use is important in Korea.
医疗程序带来的辐射暴露量正在迅速增加。我们旨在估计韩国因诊断性医疗辐射暴露而导致的癌症发病率和死亡率的比例。
使用包括国家健康检查（国民健康保险服务）、私人健康检查和征兵健康检查在内的各种来源的诊断性医疗辐射暴露信息；按性别和 5 岁年龄组计算所有诊断性医疗辐射使用的年平均暴露器官剂量（mGy），最高可达 80 岁。使用估计的暴露器官剂量和电离辐射的生物学效应（BEIR VII 模型）（超额相对风险和超额绝对风险）计算至 85 岁的癌症发病率和死亡率终生归因风险（LAR）。利用国家数据库中基于背景的癌症发病率和死亡率风险以及估计的 LAR，我们最终估计了癌症发病率和死亡率的人群归因分数（PAF）。
韩国所有癌症的诊断性医疗辐射暴露的 PAF 为发病率的 0.9%和死亡率的 0.9%，导致每年新增 1915 例癌症病例和 637 例癌症死亡。女性的 PAF 高于男性：分别为 1.2%和 1.7%（发病率和死亡率）与 0.6%（发病率和死亡率相同）。
2013 年韩国诊断性医疗辐射的估计 PAF 高于 2004 年英国的报告值。韩国优化诊断性医疗辐射使用的管理非常重要。
