Childhood cancer risks estimates following CT scans: an update of the French CT cohort study

Abstract

Objectives: Increased risks of central nervous system (CNS) tumors and leukemia associated with computed tomography (CT) exposure during childhood have been reported in recent epidemiological studies. However, no evidence of increased risks was suggested in a previous analysis of the French CT cohort. This study benefits from an updated cohort with a longer followup and a larger sample size of patients.Methods: The patients were followed from the date of their first CT (between 2000 and2011) until their date of cohort exit defined as the earliest among the following: 31st December 2016, date of death, date of first cancer diagnosis or date of their 18th birthday. Cancer incidence, vital status, cancer predisposing factors (PFs) and additional CT scans were collected via external national databases. Hazard ratios (HRs) associated to cumulative organ doses and sex were estimated from Cox models.Results: At the end of follow-up, mean cumulative doses were 27.7 and 10.3 mGy for the brain and the red bone marrow (RBM), respectively. In patients without PFs, an HR per 10 mGy of 1.05 (95% CI: 1.01 -1.09) for CNS tumors, 1.17 (95% CI: 1.09 -1.26) for leukemia and 0.96 (95% CI: 0.63 -1.45) for lymphoma was estimated. These estimates were not modified by the inclusion of CT scans performed outside the participating hospitals or after the inclusion period. Conclusions:This study shows statistically significant dose-response relationships for CNS tumors and leukemia for patients without PFs.

The Evidence for Excess Risk of Cancer and Non-Cancer Disease at Low Doses and Dose Rates

“…At slightly higher doses, increased risks of leukemia and brain cancer have been observed in pedi atrically-exposed groups given multiple computed tomography (CT) examinations, at doses of about 60 mGy to the respective tissues (active bone marrow, brain) (37)(38)(39)(40). Again, the excess risks in all of these studies are consistent with each other and with those observed among the Japanese atomic bomb survivors (33,(35)(36)(37)(38)(39).…”

The specific signs of lung ultrasound to diagnose pulmonary hemorrhage of the newborns: Evidence from a multicenter retrospective case-control study

“…In addition, CXR or CT causes inevitable damage to the human body, especially to newborn infants who are in the growing and developing is more serious. A much recent long-term follow-up study showed that for every 10 mGy increase in the dose of radiation received in childhood, the risk of central nervous system tumors increased 1.05 times (95% CI: 1.01–1.09), increased the risk of leukemia by 1.17 times (95% CI: 1.09–1.26) ( 8 ). Therefore, it is of great significance to explore the early diagnostic techniques without radiation damage for PH in newborn infants.…”

Risk Factors Associated with Traumatic Brain Injury and Implementation of Guidelines for Requesting Computed Tomography After Head Trauma Among Children in France

“…1,2 In the United States, TBIs are responsible for approximately 1500 deaths and more than 640 000 emergency department (ED) visits annually in children younger than 15 years of age. 3 Most (95%) pediatric head trauma (PHT) cases are mild (Glasgow coma scale [GCS], [13][14][15], but less than 10% demonstrate an intracranial lesion (including nearly 1.5% of intracranial hemorrhage [ICH]), of which 16% require neurosurgical intervention. [4][5][6] Due to its accessibility, acquisition speed, and diagnostic performance, head computed tomography (HCT) is the first imaging modality for PHT.…”