Radiation Exposure Associated With Computed Tomography in Childhood and the Subsequent Risk of Cancer: A Meta-Analysis of Cohort Studies
Radiation Exposure Associated With Computed Tomography in Childhood and the Subsequent Risk of Cancer: A Meta-Analysis of Cohort Studies
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DOI：
10.1177/1559325820923828
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发表时间：
2020-04-01
期刊：
影响因子：
2.5
通讯作者：
Zhou, Ping-Kun
中科院分区：
文献类型：
--
作者：
Huang, Ruixue;Liu, Xiaodan;Zhou, Ping-Kun
背景：计算机断层扫描（CT）在全世界范围内得到应用；方法：对1990年1月至2018年11月期间PubMed、SpringerLink、Embase、Cochrane Library、Elsevier/ScienceDirect、Medline、Orbis和Web of Science数据库等电子数据库进行了全面检索，以进行观察性流行病学研究，报告儿童时期CT辐射暴露与随后的癌症风险之间的关联。采用线性模型探讨剂量反应关系。结果：纳入7项研究，共纳入1180987名儿童。接触 CT 的儿童后期罹患癌症的风险是未接触 CT 的儿童的 1.32 倍。与未接受儿科 CT 治疗的患者相比，剂量较高但 CI 较宽的相对风险 (RR) 较大（5-10 mGy 的 RR：0.90，95% CI：0.69-1.12；10-15 mGy 的 RR：1.02，95% CI：0.86-1.18；>15 mGy 的 RR：1.13， 95% CI: 0.97-1.30），暴露儿童的白血病风险较高（RR：1.23，95% CI：1.10-1.36），暴露儿童的脑癌风险较高（RR：1.54，95% CI：0.84-2.45）。结论：我们的分析表明，儿童时期 CT 辐射暴露与随后患癌症的风险升高相关。然而，由于研究之间的异质性，在解释这些结果时需要谨慎。这些发现应在进一步的研究中得到更长随访期的证实。
Background:Computed tomography (CT) is used worldwide; however, recent studies suggest that CT radiation exposure during childhood may be a risk factor for cancer, although the data are inconsistent.Methods:A comprehensive search of electronic databases including PubMed, SpringerLink, Embase, Cochrane Library, Elsevier/ScienceDirect, Medline, Orbis, and Web of Science databases from January 1990 to November 2018 for observational epidemiologic studies reporting associations between radiation exposure from CT in childhood and the subsequent risk of cancer was conducted. A linear model was used to explore the dose-response relationship.Results:Seven studies with 1180 987 children enrolled were included. The risk of later cancer was 1.32-fold higher for children exposed to CT than those without exposure. Compared to those not exposed to pediatric CT, the relative risk (RRs) were larger for the higher doses but with wider CIs (RR for 5-10 mGy: 0.90, 95% CI: 0.69-1.12; RR for 10-15 mGy: 1.02, 95% CI: 0.86-1.18; RR for >15 mGy: 1.13, 95% CI: 0.97-1.30), the leukemia risk was higher in exposed children (RR: 1.23, 95% CI: 1.10-1.36), and brain cancer risk was higher in exposed children (RR: 1.54, 95% CI: 0.84-2.45).Conclusions:Our analysis suggested that radiation exposure from CT during childhood is associated with a subsequently elevated risk of cancer. However, caution is needed when interpreting these results because of the heterogeneity among the studies. The findings should be confirmed in further studies with longer follow-up periods.