美国牙科诊所 X 射线辐射相关癌症的估算：值得冒险吗？

Estimation of x-ray radiation related cancers in US dental offices: Is it worth the risk?

机构信息

Retired Professor, Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, Creighton University, Omaha, NE, USA; Professor Emeritus, Division of Oral and Maxillofacial Radiology, Department of Oral Sugery, University of Florida, Gainesville, FL, USA.

Former Professor and Chair, Section of Health Services Research, The Ohio State University College of Dentistry, Columbus, OH, USA.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Nov;132(5):597-608. doi: 10.1016/j.oooo.2021.01.027. Epub 2021 Jan 30.

DOI:10.1016/j.oooo.2021.01.027

PMID:33741287

Abstract

OBJECTIVES

The objective of this study was to estimate the possible number of cancer cases produced during 2019 in US dental offices from radiography, estimate the possible reduction in those rates resulting from use of intraoral rectangular collimation and selection criteria, and determine the frequency and quality of website radiation risk information and informed consent forms.

STUDY DESIGN

An analysis of dental radiation examinations in 2014 to 2015 US national survey data, Nationwide Evaluation of X-ray Trends, and National Council on Radiation Protection and Measurements surveys was performed, in addition to an analysis of 2008 to 2020 Journal of Clinical Orthodontics national orthodontic surveys for radiographic examination frequencies. Lifetime attributable cancer risk estimates from US and European studies were used to generate the total dental and orthodontic office cancer totals. In total, 150 offices were examined online for the quality and frequency of risk information in websites and consent forms.

RESULTS

The 2019 estimate for all office cancers is 967. Collimation and selection criteria could reduce this to 237 cancer cases. Most cancers arise from intraoral and cone beam computed tomography examinations, with 135 orthodontic cancers over 21 months (average treatment time). Collimation and selection criteria could reduce this to 68. Only 1% of offices use collimators or informed consent for radiography. The website and consent information were of poor quality.

CONCLUSIONS

Dentists are not following selection criteria or using collimators according to guidelines. Up to 75% of cancer cases could be avoided.

摘要

目的

本研究旨在估算 2019 年美国牙科诊所放射检查导致的癌症病例数，评估使用口腔内矩形准直器和选择标准可能降低的癌症发病率，并确定网站辐射风险信息和知情同意书的频率和质量。

研究设计

对 2014 年至 2015 年美国全国调查数据、全国 X 射线趋势评估和全国辐射防护与测量委员会调查中的牙科放射检查进行分析，并对 2008 年至 2020 年《临床正畸学杂志》全国正畸调查中的放射检查频率进行分析。使用美国和欧洲研究中的终生归因癌症风险估计来生成牙科和正畸办公室的癌症总数。共在线检查了 150 个办公室，以评估网站和同意书中风险信息的频率和质量。

结果

2019 年所有办公室癌症的估计值为 967 例。准直器和选择标准可将其减少至 237 例癌症病例。大多数癌症源自口腔内和锥形束计算机断层扫描检查，在 21 个月的平均治疗时间内，有 135 例正畸癌症。准直器和选择标准可将其减少至 68 例。只有 1%的办公室在放射检查中使用准直器或知情同意。网站和同意信息质量较差。