Parker Lucy A, Moreno-Garijo Andrea, Chilet-Rosell Elisa, Lorente Fermina, Lumbreras Blanca
Department of Public Health, University Miguel Hernández de Elche, 03550 Alicante, Spain.
CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
Life (Basel). 2023 Jan 20;13(2):289. doi: 10.3390/life13020289.
(1) Background: The frequency of imaging tests grew exponentially in recent years. This increase may differ according to a patient's sex, age, or socioeconomic status. We aim to analyze the impact of the Council Directive 2013/59/Euratom to control exposure to radiation for men and women and explore the impact of patients' age and socioeconomic status; (2) Methods: The retrospective observational study that includes a catchment population of 234,424. We included data of CT, mammography, radiography (conventional radiography and fluoroscopy) and nuclear medicine between 2007-2021. We estimated the associated radiation effective dose per test according using previously published evidence. We calculated a deprivation index according to the postcode of their residence. We divided the study in 2007-2013, 2014-2019 and 2020-2021 (the pandemic period). (3) Results: There was an increase in the number of imaging tests received by men and women after 2013 ( < 0.001), and this increase was higher in women than in men. The frequency of imaging tests decreased during the pandemic period (2020-2021), but the frequency of CT and nuclear medicine tests increased even during these years ( < 0.001) and thus, the overall effective mean dose. Women and men living in the least deprived areas had a higher frequency of imaging test than those living in the most deprived areas. (4) Conclusions: The largest increase in the number of imaging tests is due to CTs, which account for the higher amount of effective dose. The difference in the increase of imaging tests carried out in men and women and according to the socioeconomic status could reflect different management strategies and barriers to access in clinical practice. Given the low impact of the available recommendations on the population exposure to radiation and the performance of high-dose procedures such as CT, deserve special attention when it comes to justification and optimization, especially in women.
(1) 背景：近年来，成像检查的频率呈指数增长。这种增长可能因患者的性别、年龄或社会经济地位而异。我们旨在分析欧盟理事会指令2013/59/Euratom对控制男性和女性辐射暴露的影响，并探讨患者年龄和社会经济地位的影响；(2) 方法：这项回顾性观察研究纳入了234424名服务区域内的人群。我们纳入了2007年至2021年间CT、乳腺X线摄影、放射成像（传统放射摄影和荧光透视）及核医学的数据。我们根据先前发表的证据估算每次检查的相关辐射有效剂量。我们根据其居住邮政编码计算了贫困指数。我们将研究分为2007 - 2013年、2014 - 2019年和2020 - 2021年（疫情期间）。(3) 结果：2013年后，男性和女性接受的成像检查数量有所增加（<0.001），且女性的增幅高于男性。疫情期间（2020 - 2021年）成像检查的频率有所下降，但CT和核医学检查的频率在这些年甚至有所增加（<0.001），因此总体有效平均剂量也增加了。生活在最不贫困地区的女性和男性比生活在最贫困地区的人接受成像检查的频率更高。(4) 结论：成像检查数量增加最多的是CT，其有效剂量占比更高。男性和女性进行的成像检查增加量以及根据社会经济地位的差异可能反映了临床实践中不同的管理策略和获取障碍。鉴于现有建议对人群辐射暴露及CT等高剂量检查的实施影响较小，在进行正当性论证和优化时应特别关注，尤其是对女性。
