Projected cancer risks from computed tomographic scans performed in the United States in 2007.
Projected cancer risks from computed tomographic scans performed in the United States in 2007.
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DOI：
10.1001/archinternmed.2009.440
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发表时间：
2009-12-14
影响因子：
--
通讯作者：
Land C
中科院分区：
文献类型：
--
作者：
Berrington de González A;Mahesh M;Kim KP;Bhargavan M;Lewis R;Mettler F;Land C
自1993年以来，美国计算机断层扫描（CT）的使用增加了3倍多，每年扫描约7000万次。尽管有巨大的医疗效益，但也有人担心潜在的与辐射有关的癌症风险。我们根据年龄、性别和扫描类型对美国当前CT扫描使用的未来癌症风险进行了详细估计。基于国家研究委员会“电离辐射的生物效应”报告的风险模型和来自国家调查的器官特异性辐射剂量被用于估计每种扫描类型的年龄特异性癌症风险。这些模型与2007年美国年龄和性别特定的扫描频率相结合，这些扫描频率来自调查和保险索赔数据。我们使用蒙特卡罗模拟，以95%的不确定性限（UL）估计了与辐射相关的癌症事件的平均数量。总体而言，我们估计2007年美国约有29000例（95% UL， 15000 - 45000例）未来癌症可能与CT扫描有关。贡献最大的是腹部和骨盆扫描（n = 14000） （95% UL, 6900- 25000）、胸部（n = 4100） （95% UL, 1900-8100）和头部（n = 4000） （95% UL, 1100-8700），以及胸部CT血管造影（n = 2700） （95% UL, 1300-5000）。三分之一的预测癌症是由于在35至54岁之间进行的扫描，相比之下，15%是由于在18岁以下进行的扫描，66%是女性。这些详细的估计强调了CT扫描使用对总癌症风险有很大贡献的几个领域，包括使用频率高的几种扫描类型和年龄组，或涉及相对高剂量的扫描，在这些领域可能需要采取降低风险的措施。
The use of computed tomographic (CT) scans in the United States (US) has increased more than 3-fold since 1993 to approximately 70 million scans annually. Despite the great medical benefits, there is concern about the potential radiation-related cancer risk. We conducted detailed estimates of the future cancer risks from current CT scan use in the US according to age, sex, and scan type. Risk models based on the National Research Council’s “Biological Effects of Ionizing Radiation” report and organ-specific radiation doses derived from a national survey were used to estimate age-specific cancer risks for each scan type. These models were combined with age- and sex-specific scan frequencies for the US in 2007 obtained from survey and insurance claims data. We estimated the mean number of radiation-related incident cancers with 95% uncertainty limits (UL) using Monte Carlo simulations. Overall, we estimated that approximately 29 000 (95% UL, 15 000-45 000) future cancers could be related to CT scans performed in the US in 2007. The largest contributions were from scans of the abdomen and pelvis (n = 14 000) (95% UL, 6900-25 000), chest (n = 4100) (95% UL, 1900-8100), and head (n = 4000) (95% UL, 1100-8700), as well as from chest CT angiography (n = 2700) (95% UL, 1300-5000). One-third of the projected cancers were due to scans performed at the ages of 35 to 54 years compared with 15% due to scans performed at ages younger than 18 years, and 66% were in females. These detailed estimates highlight several areas of CT scan use that make large contributions to the total cancer risk, including several scan types and age groups with a high frequency of use or scans involving relatively high doses, in which risk-reduction efforts may be warranted.
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影响因子：
--
作者：
Kim, Kwang Pyo;Einstein, Andrew J.;de Gonzalez, Amy Berrington
通讯作者：
de Gonzalez, Amy Berrington
影响因子：
19.7
作者：
Brenner, DJ;Elliston, CD
通讯作者：
Elliston, CD
影响因子：
19.7
作者：
Little, Mark P.;Wakeford, Richard;de Gonzalez, Amy Berrington
通讯作者：
de Gonzalez, Amy Berrington
DOI：
10.1016/j.jacr.2007.03.002
发表时间：
2007-05-01
期刊：
Journal of the American College of Radiology : JACR
影响因子：
--
作者：
Amis, E Stephen Jr;Butler, Priscilla F;Zeman, Robert K
通讯作者：
Zeman, Robert K
影响因子：
5
作者：
Griffey, Richard T.;Sodickson, Aaron
通讯作者：
Sodickson, Aaron