Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Rationale and Framework for the Monograph and Overview of Eligible Studies.
Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Rationale and Framework for the Monograph and Overview of Eligible Studies.
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低剂量电离辐射和癌症的流行病学研究：合格研究专着和概述的理由和框架。
DOI：
10.1093/jncimonographs/lgaa009
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发表时间：
2020-07-01
期刊：
影响因子：
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通讯作者：
Schubauer-Berigan MK
中科院分区：
文献类型：
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作者：
Berrington de Gonzalez A;Daniels RD;Cardis E;Cullings HM;Gilbert E;Hauptmann M;Kendall G;Laurier D;Linet MS;Little MP;Lubin JH;Preston DL;Richardson DB;Stram D;Thierry-Chef I;Schubauer-Berigan MK
低剂量电离辐射是否致癌是辐射防护领域长期争论的一个重要问题。自2006年美国国家科学院发表电离辐射的生物效应报告以来，来自大规模、有力的低剂量流行病学研究的新出版物报告了积极的剂量-反应关系。然而，有人认为，偏见可以解释这些发现。我们对2006-2017年发表的平均剂量低于100 mGy的流行病学研究进行了系统综述。我们需要个体化的剂量和剂量反应估计与置信区间。我们确定了26项合格的研究（8项环境研究，4项医学研究和14项职业研究），包括91000例实体癌和13000例白血病。平均剂量范围为0.1至82 mGy。在100 mGy剂量下，22项实体癌研究中有16项和20项白血病研究中有17项的超额相对风险为阳性。本专著的目的是系统地审查这些研究中的潜在偏倚（包括剂量不确定性、混杂和结果错误分类），并评估偏倚最小的研究子集是否为低剂量辐射的癌症风险提供了证据。在这里，我们描述了系统偏倚综述的框架，并提供了合格研究的概述。
Whether low-dose ionizing radiation can cause cancer is a critical and long-debated question in radiation protection. Since the Biological Effects of Ionizing Radiation report by the National Academies in 2006, new publications from large, well-powered epidemiological studies of low doses have reported positive dose-response relationships. It has been suggested, however, that biases could explain these findings. We conducted a systematic review of epidemiological studies with mean doses less than 100 mGy published 2006–2017. We required individualized doses and dose-response estimates with confidence intervals. We identified 26 eligible studies (eight environmental, four medical, and 14 occupational), including 91 000 solid cancers and 13 000 leukemias. Mean doses ranged from 0.1 to 82 mGy. The excess relative risk at 100 mGy was positive for 16 of 22 solid cancer studies and 17 of 20 leukemia studies. The aim of this monograph was to systematically review the potential biases in these studies (including dose uncertainty, confounding, and outcome misclassification) and to assess whether the subset of minimally biased studies provides evidence for cancer risks from low-dose radiation. Here, we describe the framework for the systematic bias review and provide an overview of the eligible studies.