Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Neuroepidemiology. 2020;54(4):343-355. doi: 10.1159/000506131. Epub 2020 Mar 20.
We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study.
MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors.
Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest.
There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.
我们探讨了产前和产后放射诊断程序中的电离辐射(IR)与 MOBI-kids 研究中的脑癌风险之间的关联。
MOBI-kids 是一项国际(澳大利亚、奥地利、加拿大、法国、德国、希腊、印度、以色列、意大利、日本、韩国、新西兰、西班牙、荷兰)病例对照研究,纳入了 899 名年龄在 10-24 岁的脑肿瘤(645 例神经上皮肿瘤)病例和 1910 名性别、年龄匹配的对照。通过个人访谈收集了医学放射病史。我们根据年龄和时间段构建了一个查找表,为每个程序估算脑 IR 剂量。使用从诊断日期开始的 2 年和 5 年滞后计算终生累积剂量。使用条件逻辑回归估计风险。评估了神经、心理和遗传状况作为潜在的混杂因素。主要分析集中在神经上皮肿瘤上。
总体而言,剂量非常低,呈偏态分布(中位数 0.02 mGy,最大值 217 mGy)。产后暴露的 OR 通常低于 1。在最高剂量类别中,无论是产前还是产后暴露,OR 均增加:分别为 1.63(95%CI 0.44-6.00)和 1.55(0.57-4.23),但病例数量非常少。在调整医疗状况后,风险估计值的变化幅度较小。
放射诊断程序中的 IR 与儿童和青少年脑肿瘤风险之间几乎没有关联的证据。尽管剂量非常低,但我们的结果表明,产前和生命早期暴露的风险更高,这与当前的证据一致。