Regional Deprivation and Non-Cancer Related Computed Tomography Use in Pediatric Patients in Germany: Cross-Sectional Analysis of Cohort Data

Dreger, Steffen; Krille, Lucian; Maier, Werner; Pokora, Roman; Blettner, Maria; Zeeb, Hajo

doi:10.1371/journal.pone.0153644

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…The findings in our study differed from those in the European and North American studies reporting the use of CT scan by SES, where a highest CT scan use was observed in vulnerable areas compared to the CT scan use in less deprived areas [ 6 – 9 ]. Head scans were significantly associated to deprivation in the UK study [ 6 ], suggesting that head injuries were the main reason behind the cumulative excess radiation doses received by the study population.…”

Section: Discussioncontrasting

confidence: 99%

“…For example, the Dutch study used measures of material deprivation (home income and home value) whereas the Townsend deprivation index used in UK incorporates employment in addition to material deprivation indicators [ 6 , 8 ]. In the Australian [ 4 ], German [ 9 ] and in the present study the indexes used to explain the socioeconomic reality of the study population were more relatable, although the overlapping of the social dimensions included in each index was incomplete.…”

Section: Discussionmentioning

confidence: 82%

“…Four recent papers have reported higher radiation doses and CT scan use in children living in disadvantaged areas [ 6 – 9 ]. In all of them, this finding was hypothetically attributed to a higher disease and injury rate compared to more affluent areas.…”

Section: Introductionmentioning

confidence: 99%

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CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

et al. 2018

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Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 82%

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CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

et al. 2018

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“…SES may confound the association between radiation dose and brain tumor risk in this study as parents of controls tended to have higher education levels (thus, likely, higher level of SES) compared to parents of cases. However, recent reports, show no consistent association between SES and CT-scan exposure [18,[41][42][43][44]. We tested if parental education was related to cumulative dose, and found no association.…”

Section: Discussionmentioning

confidence: 84%

Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study

Pasqual¹,

Castaño‐Vinyals²,

Thierry-Chef³

et al. 2020

Neuroepidemiology

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Background: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. Methods: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10–24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. Results: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44–6.00) and 1.55 (0.57–4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. Conclusions: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.

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“…The use of CT scans has grown rapidly worldwide in recent decades (1)(2)(3)(4)(5)(6)(7). In 2005, about 8.2 million CT scans were performed in Germany, with a child CT ratio of about 1% (8).…”

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confidence: 99%

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

et al. 2021

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Background: Computerized Tomographic (CT) scan is a rapid, non-invasive, and common diagnostic modality in radiology. More and faster growth of cells, as well as longer lifespan of a child, may lead to a cumulative effect of radiation and a greater chance of mutation, especially in children who are more vulnerable. Objectives: This study was designed to evaluate the current trend in the use of this modality. Methods: In this descriptive study, all cases of children admitted to Taleghani Hospital who were studied by CT scan during the years 2018 - 2019, entered in survey. Demographic information, anatomical location of the scan, findings from the CT scan report, initial and final diagnosis, number of scans, patient’s complaint that led to his hospitalization and total amount of radiation received by the patient were analyzed. The data were analyzed by SPSS software version 23 with descriptive statistics (frequency, frequency percentage, and mean and standard deviation). Results: In this study, 344 scans of 280 patients were reviewed. Out of 280 patients, 222 patients underwent scan from one, 55 patients from two and four patients from three different anatomical locations. There were 146 male patients (52.1%) with a mean age of 57.7 months and 134 female patients (47.9%) with a mean age of 54.7 months. Out of all scans, the brain was reported with 45%, chest 30%, and other areas 25%. The CT scan was performed at the request of the doctor in charge. Pneumonia (19%) followed by convulsion (17%) and febrile seizures (12%) were the most common complaints. The number of completely normal CT was 151 scans (44.02%), with brain scans having the highest rate of normal scans with 74.19%. Brain scans with an average of 358.66 milliGray.centimeter (mGy.cm) and a maximum of 995.30 mG/cm had the highest average absorbed dose. Conclusions: In this study, the rate of normal CT scans was relatively high and the range of rays available for each modality was significantly wide. Effective interventions must be made in this regard.

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Regional Deprivation and Non-Cancer Related Computed Tomography Use in Pediatric Patients in Germany: Cross-Sectional Analysis of Cohort Data

Cited by 7 publications

References 21 publications

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

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