Risk of hematologic cancers from repeated low-dose diagnostic radiation

重复低剂量诊断辐射导致血液癌的风险

• 批准号: 8772719
• 负责人: Lydia B Zablotska
• 金额: $ 7.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-05 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8772719
• 关键词: Address; Adult; Age; Alcohols; Area; Bone Marrow; Cardiovascular system; Cohort Studies; Country; Data; Data Set; Diagnostic; Diagnostic radiologic examination; Dose; Dose Fractionation; Epidemiologic Studies; Epidemiology; Etiology; Evaluation; Exposure to; Fluoroscopy; Fractionation; Frequencies; Genetic; Health; Hematologic Neoplasms; Heterogeneity; Image; Imaging Techniques; Individual; Ionizing radiation; Japan; Japanese Population; Knowledge; Lead; Low Dose Radiation; Massachusetts; Medical; Meta-Analysis; Modeling; Monitor; Multiple Myeloma; Myocardial Ischemia; National Cancer Institute; Non-Hodgkin' s Lymphoma; Occupational Exposure; Organ; Outcome; Patients; Policies; Policy Maker; Population; Procedures; Public Health; Publishing; Radiation; Reporting; Research; Research Design; Research Personnel; Risk; Risk Estimate; Risk Factors; Roentgen Rays; Safety; Sampling Studies; Scanning; Smoking; Source; Specific qualifier value; Study Subject; Survivors; Time; Tobacco; Tuberculosis; Woman; Work; X-Ray Computed Tomography; base; cancer epidemiology; cancer genetics; cancer risk; carcinogenesis; chemotherapy; cohort; design; follow-up; improved; interest; leukemia; men; modifiable risk; mortality; novel; population based; public health relevance; residence; social; trend; tuberculosis treatment

DESCRIPTION (provided by applicant): A large proportion of the U.S. population comes into contact with small doses of ionizing radiation through occupational exposures or from background ionizing radiation. More recently, an additional and increasing source of radiation exposure is from medical diagnostic radiation examinations, such as X-rays and computed tomography (CT) scans. While the risk of leukemia from high doses of ionizing radiation are well known, the risk of other hematologic cancers, such as multiple myeloma (MM) or non-Hodgkin lymphoma (NHL), are not well understood. Neither are the risks from lower radiation doses that are protracted over time. We propose to examine the association between diagnostic X-rays and hematologic cancer outcomes by pooling the data from a large Canadian Fluoroscopy cohort study with data from a similar study in Massachusetts, conducted by the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetics, the National Cancer Institute (NCI). Fluoroscopy is an imaging technique that uses X-rays to obtain real-time moving images of patient's organs. Patients from the Canadian and NCI cohorts received repeated X-ray fluoroscopic examinations in the course of treatment for tuberculosis. Neither study has examined risks of hematologic cancers in the past. This proposed study of radiation-related risks of hematologic cancers in the pooled analysis of fluoroscopy studies (HemFluoro study) will include 77,100 patients with more than 50 years of follow up for mortality from hematologic cancers. Analyses will be based on 222 cases of leukemia, 70 cases of multiple myeloma and 183 cases of non-Hodgkin lymphoma, making it the largest study of hematologic cancers in a population exposed to low doses of diagnostic ionizing radiation. Study findings will be directly relevant for risk projections for the U.S. population exposed to CT scans because of similarity of background rates of hematologic cancers and of radiation exposures. The study sample will include men and women of a wide range of ages and additionally will have extensive data on modifiable risk factors, such as smoking. Evaluation of modifiable risk factors is one of the four key areas of research specified in the PAR-12-039 announcement. The overall scientific objective is to expand the existing body of knowledge on radiation-related risks of leukemia, MM and NHL and to address remaining gaps in knowledge with respect to radiation-related carcinogenesis at low-dose radiation exposures. Results from this study will stimulate further research on hematologic cancers in different populations. The public health impact of this study will be significant because we will assess the appropriateness of current public radiation safety limits, which are primarily based on the studies of subjects exposed to high doses of ionizing radiation.

描述（由申请人提供）：很大一部分美国人通过职业暴露或背景电离辐射接触小剂量的电离辐射。最近，另一个不断增加的辐射暴露来源是医学诊断辐射检查，例如 X 射线和计算机断层扫描 (CT) 扫描。虽然高剂量电离辐射导致白血病的风险众所周知，但其他血液癌症（如多发性骨髓瘤 (MM) 或非霍奇金淋巴瘤 (NHL)）的风险尚不清楚。随着时间的推移，较低辐射剂量带来的风险也不会增加。我们建议通过将加拿大大型透视队列研究的数据与美国国家癌症研究所 (NCI) 癌症流行病学和遗传学部放射流行病学分部在马萨诸塞州进行的一项类似研究的数据进行汇总，来检查诊断 X 射线与血液学癌症结果之间的关联。透视检查是一种利用 X 射线获取患者器官实时移动图像的成像技术。来自加拿大和 NCI 队列的患者在结核病治疗过程中接受了反复的 X 射线透视检查。过去两项研究都没有检查血液癌症的风险。这项拟议的透视检查研究汇总分析（HemFluoro 研究）中血液癌症辐射相关风险的研究将包括 77,100 名患者，并对血液癌症死亡率进行了 50 多年的随访。分析将基于 222 例白血病、70 例多发性骨髓瘤和 183 例非霍奇金淋巴瘤病例，这使其成为针对暴露于低剂量诊断电离辐射人群的血液癌症的最大规模研究。由于血液癌症和辐射暴露的背景率相似，研究结果将直接与接受 CT 扫描的美国人群的风险预测相关。研究样本将包括各个年龄段的男性和女性，此外还将拥有有关可改变风险因素（例如吸烟）的大量数据。可改变风险因素的评估是 PAR-12-039 公告中指定的四个关键研究领域之一。总体科学目标是扩大有关白血病、多发性骨髓瘤和非霍奇金淋巴瘤的辐射相关风险的现有知识体系，并弥补低剂量辐射照射下与辐射相关的致癌作用方面的知识空白。这项研究的结果将刺激对不同人群的血液癌症的进一步研究。这项研究对公共健康的影响将是重大的，因为我们将评估当前公共辐射安全限值的适当性，这些安全限值主要基于对暴露于高剂量电离辐射的受试者的研究。