ePrints

Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions

Lookup NU author(s): Dr Jane Salotti, Dr Richard Harbron, Emeritus Professor Alan Craft, Professor Mark PearceORCiD

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.

Abstract

Background: We previously reported evidence of a dose-response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these findings.Methods: We collected and reviewed additional clinical information from radiology information systems (RIS) databases, underlying cause of death and pathology reports. We conducted sensitivity analyses excluding participants with cancer-predisposing conditions or previous unreported cancers and compared the dose-response analyses with our original results.Results: We obtained information from the RIS and death certificates for about 40% of the cohort (n similar to 180 000) and found cancer-predisposing conditions in 4 out of 74 leukaemia/myelodysplastic syndrome (MDS) cases and 13 out of 135 brain tumour cases. As these conditions were unrelated to CT exposure, exclusion of these participants did not alter the dose-response relationships. We found evidence of previous unreported cancers in 2 leukaemia/MDS cases, 7 brain tumour cases and 232 in non-cases. These previous cancers were related to increased number of CTs. Exclusion of these cancers reduced the excess relative risk per mGy by 15% from 0.036 to 0.033 for leukaemia/MDS (P-trend = 0.02) and by 30% from 0.023 to 0.016 (P-trend < 0.0001) for brain tumours. When we included pathology reports we had additional clinical information for 90% of the cases. Additional exclusions from these reports further reduced the risk estimates, but this sensitivity analysis may have underestimated risks as reports were only available for cases.Conclusions: Although there was evidence of some bias in our original risk estimates, re-analysis of the cohort with additional clinical data still showed an increased cancer risk after low-dose radiation exposure from CT scans in young patients.

Publication metadata

Author(s): de Gonzalez AB, Salotti JA, McHugh K, Little MP, Harbron RW, Lee C, Ntowe E, Braganza MZ, Parker L, Rajaraman P, Stiller C, Stewart DR, Craft AW, Pearce MS

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2016

Volume: 114

Issue: 4

Pages: 388-394

Online publication date: 16/02/2016

Acceptance date: 01/11/2015

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/bjc.2015.415

DOI: 10.1038/bjc.2015.415

Altmetrics

Share