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Whats New in the
Patient Safety World
June 2023
Childhood CT Scans and Cancer Risk
For years there has
been debate about cumulative radiation dose and the subsequent risk of
developing cancer (see list of our prior columns below). The special concern
has been in children who receive multiple CT scans.
The most recent
statistics on the issue come from Taiwan. Wang et al. (Wang 2023) analyzed data
from Taiwans publicly funded health care system. They identified participants
younger than 25 years with newly diagnosed intracranial tumors, leukemia or lymphoma, from 2000, to 2013 and compared them
to 10 non-cancer controls for each case, matching by sex, date of birth and day
of entry to the cohort.
Compared with no exposure, exposure to a single pediatric CT
scan did not increase risk of intracranial tumors, leukemia
or lymphoma. Those who received 2-3 CT scans had an increased risk of
intracranial tumor (adjusted OR 2.36), but not leukemia, non-Hodgkin lymphoma
or Hodgkin lymphoma. Those exposed to 4 or more CT scans had an elevated incidence
(IRR 2.30) of one of these cancer outcomes. Age of exposure was a significant
risk factor as well. Receiving 4 or more CT scans at or before 6 years of age
was associated with the highest risks of cancer, followed by ages 7-12 years
and 13-18 years.
The findings of this study once again underscore the
importance of prudent use of CT scanning in the pediatric population. Programs
like Imaging Gentlyฎ and SCANSMART have focused on reducing unnecessary CT
imaging in children and minimizing radiation dose in those cases where CT
scanning is appropriate.
Some of our previous
columns on the issue of radiation risk:
- February 2, 2010 The
Hazards of Radiation
- November 23, 2010 Focus on Cumulative Radiation Exposure
- March 2010 More
on Radiation Safety
- June 2011 Progress
in Reducing Radiation from CT Scans
- April 2013 Radiation Risk of CT Scans: Debate
Continues
- June 4, 2013 Reducing Unnecessary CT
Scans
- July 2013 More on the CT/Cancer Debate
- January 2017 Still
Too Many CT Scans for Pediatric Appendicitis
- November 2017 SCANSMART
Program to Use CT Safely in Children
References:
Wang W-H, Sung C-Y, Wang S-C, Shao Y-HJ. Risks of leukemia,
intracranial tumours and lymphomas in childhood and
early adulthood after pediatric radiation exposure from computed tomography. CMAJ
2023; 195(16): E575-E583
https://www.cmaj.ca/content/195/16/E575
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Whats New in
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