Huang Ruixue, Liu Xiaodan, He Li, Zhou Ping-Kun
Department of Occupational and Environmental Health, Xiangya School of Public Heath, Central South University, Changsha, Hunan Province, People's Republic of China.
Department of Radiation Biology, Beijing Key Laboratory for Radiobiology, Beijing Institute of Radiation Medicine, AMMS, Beijing, People's Republic of China.
Dose Response. 2020 May 5;18(2):1559325820923828. doi: 10.1177/1559325820923828. eCollection 2020 Apr-Jun.
Computed tomography (CT) is used worldwide; however, recent studies suggest that CT radiation exposure during childhood may be a risk factor for cancer, although the data are inconsistent.
A comprehensive search of electronic databases including PubMed, SpringerLink, Embase, Cochrane Library, Elsevier/ScienceDirect, Medline, Orbis, and Web of Science databases from January 1990 to November 2018 for observational epidemiologic studies reporting associations between radiation exposure from CT in childhood and the subsequent risk of cancer was conducted. A linear model was used to explore the dose-response relationship.
Seven studies with 1180 987 children enrolled were included. The risk of later cancer was 1.32-fold higher for children exposed to CT than those without exposure. Compared to those not exposed to pediatric CT, the relative risk (RRs) were larger for the higher doses but with wider CIs (RR for 5-10 mGy: 0.90, 95% CI: 0.69-1.12; RR for 10-15 mGy: 1.02, 95% CI: 0.86-1.18; RR for >15 mGy: 1.13, 95% CI: 0.97-1.30), the leukemia risk was higher in exposed children (RR: 1.23, 95% CI: 1.10-1.36), and brain cancer risk was higher in exposed children (RR: 1.54, 95% CI: 0.84-2.45).
Our analysis suggested that radiation exposure from CT during childhood is associated with a subsequently elevated risk of cancer. However, caution is needed when interpreting these results because of the heterogeneity among the studies. The findings should be confirmed in further studies with longer follow-up periods.
计算机断层扫描(CT)在全球范围内广泛应用;然而,近期研究表明,儿童时期接受CT辐射可能是患癌的一个风险因素,尽管数据并不一致。
全面检索电子数据库,包括1990年1月至2018年11月期间的PubMed、SpringerLink、Embase、Cochrane图书馆、爱思唯尔/科学Direct、Medline、Orbis和科学网数据库,以查找报告儿童时期CT辐射暴露与后续患癌风险之间关联的观察性流行病学研究。使用线性模型探索剂量反应关系。
纳入了7项研究,共1180987名儿童。接受CT检查的儿童患癌风险比未接受检查的儿童高1.32倍。与未接受儿科CT检查的儿童相比,高剂量组的相对风险(RR)更大,但置信区间更宽(5 - 10 mGy时RR:0.90,95% CI:0.69 - 1.12;10 - 15 mGy时RR:1.02,95% CI:0.86 - 1.18;>15 mGy时RR:1.13,95% CI:0.97 - 1.30),接受检查的儿童白血病风险更高(RR:1.23,95% CI:1.10 - 1.36),患脑癌风险也更高(RR:1.54,95% CI:0.84 - 2.45)。
我们的分析表明,儿童时期CT辐射暴露与随后患癌风险升高有关。然而,由于研究之间存在异质性,在解释这些结果时需要谨慎。这些发现应在随访期更长的进一步研究中得到证实。