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Computed tomographies and cancer risk in children: a literature overview of CT practices, risk estimations and an epidemiologic cohort study proposal

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Abstract

Radiation protection is a topic of great public concern and of many scientific investigations, because ionizing radiation is an established risk factor for leukaemia and many solid tumours. Exposure of the public to ionizing radiation includes exposure to background radiation, as well as medical and occupational exposures. A large fraction of the exposure from diagnostic procedures comes from medical imaging. Computed tomography (CT) is the major single contributor of diagnostic radiation exposure. An increase in the use of CTs has been reported over the last decades in many countries. Children have smaller bodies and lower shielding capacities, factors that affect the individual organ doses due to medical imaging. Several risk models have been applied to estimate the cancer burden caused by ionizing radiation from CT. All models predict higher risks for cancer among children exposed to CT as compared to adults. However, the cancer risk associated with CT has not been assessed directly in epidemiological studies. Here, plans are described to conduct an historical cohort study to investigate the cancer incidence in paediatric patients exposed to CT before the age of 15 in Germany. Patients will be recruited from radiology departments of several hospitals. Their individual exposure will be recorded, and time-dependent cumulative organ doses will be calculated. Follow-up for cancer incidence via the German Childhood Cancer Registry will allow computation of standardized incidence ratios using population-based incidence rates for childhood cancer. Dose–response modelling and analyses for subgroups of children based on the indication for and the result of the CT will be performed.

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Acknowledgments

The feasibility study was and the main cohort study will be funded by the German Federal Ministry of Education and Research under the grant numbers 02NUK007D and 02NUK016A, respectively.

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Authors and Affiliations

  1. Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany

    Lucian Krille, Gael Hammer, Peter Scholz & Maria Blettner

  2. Diagnostische und Interventionelle Radiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany

    Peter Mildenberger

  3. Institut für Epidemiologie und Präventionsforschung GmbH (BIPS), Achterstr 30, 28359, Bremen, Germany

    Hajo Zeeb

  4. Centre de Recherche Public Henri Tudor, 2A, rue Kalchesbrück, 1852, Luxembourg, Germany

    Andreas Jahnen

  5. Dr. von Haunersches Kinderspital, Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universität München, Lindwurmstr. 4, 80337, München, Germany

    Michael Seidenbusch & Karl Schneider

  6. Institut für Klinische Radiologie und Nuklearmedizin, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Gerald Weisser

Authors
  1. Lucian Krille
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  2. Hajo Zeeb
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  3. Andreas Jahnen
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  4. Peter Mildenberger
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  5. Michael Seidenbusch
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  6. Karl Schneider
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  7. Gerald Weisser
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  8. Gael Hammer
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  9. Peter Scholz
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  10. Maria Blettner
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Correspondence to Lucian Krille.

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Krille, L., Zeeb, H., Jahnen, A. et al. Computed tomographies and cancer risk in children: a literature overview of CT practices, risk estimations and an epidemiologic cohort study proposal. Radiat Environ Biophys 51, 103–111 (2012). https://doi.org/10.1007/s00411-012-0405-1

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  • DOI: https://doi.org/10.1007/s00411-012-0405-1

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