Dental x‐rays and risk of meningioma

White, Stuart C.; Hildebolt, Charles F.; Lurie, Alan G.

doi:10.1002/cncr.27709

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…A patient with such pain may receive dental x rays during the course of his/her care. It may be that radiographs do not cause meningiomas, but rather the presence of tumours triggers the need for radiographs (White et al, 2013). In other words, the dental x rays did not cause the meningiomas; the meningiomas caused the dental x rays.…”

Section: Examples Of Reverse Causation (Confounding By Indication)mentioning

confidence: 99%

Radiation epidemiology and recent paediatric computed tomography studies

Boice

2015

Ann ICRP

103

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Abstract-Recent record-linkage studies of cancer risk following computed tomography (CT)procedures among children and adolescents under 21 years of age must be interpreted with caution. The reasons why the examinations were performed were not known, and the dosimetric approaches did not include individual dose reconstructions or account for the possibility for missed examinations. The recent report (2013) on children by the United Nations Scientific Committee on the Effects of Atomic Radiation concluded that the associations may have resulted from confounding by indication (also called 'reverse causation'), and not radiation exposure. The reported cancer associations may very well have been related to the patients' underlying health conditions that prompted the examinations. Reverse causation has been observed in other epidemiological investigations, such as a Swedish study of thyroid cancer risk following I-131 scintillation imaging scans, and in studies of brain cancer risk following Thorotrast for cerebral angiography. Epidemiological patterns reported in the CT studies were also inconsistent with the world's literature. For example, in a UK study, teenagers had a higher risk of brain tumour than young children; in an Australian study, cancers not previously linked to radiation were significantly elevated; and in a Taiwanese study, the risk of benign tumours decreased with age at the time of CT examination. In all studies, solid tumours appeared much earlier than previously reported. Remarkably, in the Australian study, brain cancer excesses were seen regardless of whether or not the CT was to the head, i.e. a significant excess was reported for CT examinations of the abdomen and extremities, which involved no radiation exposure to the brain. In the UK study, the significance of the 'leukaemia' finding was only because myelodysplastic syndrome was added to the category, and there was no significance for leukaemia alone. Without knowledge of why CT examinations were performed, any future studies will be equally difficult to interpret. It is noteworthy that two recent studies of children in France and Germany found no significant excess cancer risk from CT scans once adjustment was made for conditions that prompted the scan, family This paper does not necessarily reflect the views of the International Commission on Radiological Protection. 236 history, or other predisposing factors known to be associated with increased cancer risk. Nonetheless, such studies have heightened awareness of these relatively high-dose diagnostic procedures, and the need to reduce unnecessary examinations and lower the dose per examination commensurate with the desired image quality.

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Section: Examples Of Reverse Causation (Confounding By Indication)mentioning

confidence: 99%

Radiation epidemiology and recent paediatric computed tomography studies

Boice

2015

Ann ICRP

103

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“…12 Nonetheless, recent concerns over radiation risks associated with these procedures have also been raised in dentistry, 13 particularly in association with intracranial meningioma 14,15 and thyroid cancer. 16,17 Although the validity of these epidemiologic studies has been called into serious question, 18,19 the contribution of xray exposure from dentistry to per capita annual dose may well be increasing, as is the case in diagnostic imaging in general, which now accounts for almost 50% (3000 mSv) of annual per capita radiation dose in the United States (6200 mSv). 2 Perhaps the major contributing factor in the general rise of dose in dentistry has been the rapid rise in the availability and use of cone beam computed tomography (CBCT) in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The Image Gently in Dentistry campaign: promotion of responsible use of maxillofacial radiology in dentistry for children

White

Scarfe

Schulze

et al. 2014

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…In absolute numbers, this means that 22 out of 1,433 patients reported such examinations, while this was the case for five out of 1,350 control individuals. With this result, it should be kept in mind that case-control studies possess inherent uncertainties (Mann, 2003), amplified by the method of data collection, which is based on recall of treatments which, in this case, occurred, on average, five decades previously and is prone to personal bias (see also Jorgensen, 2013;White et al, 2013). As is shown in Appendix 3, these ratios are very sensitive to even small errors.…”

mentioning

confidence: 98%