Does Imaging Technology Cause Cancer? Debunking the Linear No-Threshold Model of Radiation Carcinogenesis
Does Imaging Technology Cause Cancer? Debunking the Linear No-Threshold Model of Radiation Carcinogenesis
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DOI：
10.1177/1533034615578011
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发表时间：
2016-04-01
影响因子：
2.8
通讯作者：
Welsh, James S.
中科院分区：
文献类型：
--
作者：
Siegel, Jeffry A.;Welsh, James S.
在过去几年中，大众媒体对接受X射线、计算机断层扫描和核医学放射成像等医学成像研究的患者所接受的低剂量辐射照射的致癌性给予了极大关注。媒体的报道依据的是科学文献中发表的大量文章，这些文章声称电离辐射“没有安全剂量”，而基本上忽略了所有表明相反观点的文献。但是，这篇报道的“科学”文献反过来又将其对癌症诱发的估计建立在辐射致癌作用的线性无阈值假设之上。使用线性无阈值模型已经产生了数百篇文章，所有这些文章都预测了任何剂量的辐射都会产生明确的致癌作用，无论剂量有多小。因此，医院和专业协会已经开始了旨在减少使用某些基于感知风险的医学成像研究的运动和政策：利益比假设。然而，由于它们基本上都是基于辐射致癌的线性无阈值模型，如果线性无阈值假设是错误的，用于计算放射成像研究危害的风险：受益比模型可能是非常不准确的。在这里，我们回顾了线性无阈值模型的无数不足之处，并对基于这种过于简单化的模型的各种研究提出质疑。
In the past several years, there has been a great deal of attention from the popular media focusing on the alleged carcinogenicity of low-dose radiation exposures received by patients undergoing medical imaging studies such as X-rays, computed tomography scans, and nuclear medicine scintigraphy. The media has based its reporting on the plethora of articles published in the scientific literature that claim that there is "no safe dose" of ionizing radiation, while essentially ignoring all the literature demonstrating the opposite point of view. But this reported "scientific" literature in turn bases its estimates of cancer induction on the linear no-threshold hypothesis of radiation carcinogenesis. The use of the linear no-threshold model has yielded hundreds of articles, all of which predict a definite carcinogenic effect of any dose of radiation, regardless of how small. Therefore, hospitals and professional societies have begun campaigns and policies aiming to reduce the use of certain medical imaging studies based on perceived risk:benefit ratio assumptions. However, as they are essentially all based on the linear no-threshold model of radiation carcinogenesis, the risk:benefit ratio models used to calculate the hazards of radiological imaging studies may be grossly inaccurate if the linear no-threshold hypothesis is wrong. Here, we review the myriad inadequacies of the linear no-threshold model and cast doubt on the various studies based on this overly simplistic model.