JAMA Pediatrics:儿童CT扫描或增加致癌风险
来源:生物谷 2013-06-12 20:29
2013年6月12日讯 /生物谷BIOON/--最近发表在JAMA Pediatrics杂志上的一项研究表明曾经在1996年至2005年,采用CT对头部,腹部/盆骨,胸腔或脊髓的小于小于14岁儿童的在未来患因辐射引起的癌症的发病率升高。
2013年6月12日讯 /生物谷BIOON/--最近发表在JAMA Pediatrics杂志上的一项研究表明曾经在1996年至2005年,采用CT对头部,腹部/盆骨,胸腔或脊髓的小于小于14岁儿童的在未来患因辐射引起的癌症的发病率升高。
Diana L. Miglioretti博士是加利福尼亚大学健康研究中心教授,通过分析美国健康中心数据库,Diana L. Miglioretti博士带领的科学家研究了儿童CT使用和癌症发病率的关系。
研究人员称在近二十多年来,采用CT对儿童进行检测越来越普遍。而离子化射线比普通射线引起的癌症发病率会增高。而儿童对对辐射引起的致癌作用更敏感,多年后会引起癌症发育。
研究显示使用CT的儿童数量在2006年和2007年趋于稳定,并开始下滑。而在1996年到2005年之间CT的小于5岁的儿童使用数是稳定期的两倍,5至14岁儿童数目是稳定期的三倍。
同时研究人员发现年轻父母和女孩比年龄较大父母和男孩的实质性肿瘤发病率要高。父母做过针对腹部/骨盆或脊髓CT的儿童发病也比父母做过其他区域CT的儿童癌症发病率要高。
研究表明女孩的辐射引起的实质性肿瘤发病率高可能是由于300到390人进行了腹腔/骨盆扫描,330到480人进行了胸腔扫描,270到800人进行了脊髓扫描。进行头部扫描且年龄小于5岁儿童白血病发病率也会升高。
由于4百万儿童曾经做过CT,研究人员预计未来每年会新增4870位癌症患者。研究人员总结道,需要做更多的研究来确认儿童什么时候做CT检测容易导致癌症,是否其他成像检测方式也会有这种副作用。我们现在能做的是提醒放射学家鉴于CT能够提高致癌风险,是否值得对病人做CT检查。(生物谷Bioon.com)
The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk
Diana L. Miglioretti, Eric Johnson, Andrew Williams, Robert T. Greenlee, Sheila Weinmann, Leif I. Solberg,Heather Spencer Feigelson, Douglas Roblin, Michael J. Flynn, Nicholas Vanneman, Rebecca Smith-Bindman
Importance Increased use of computed tomography (CT) in pediatrics raises concerns about cancer risk from exposure to ionizing radiation. Objectives To quantify trends in the use of CT in pediatrics and the associated radiation exposure and cancer risk. Design Retrospective observational study. Setting Seven US health care systems. Participants The use of CT was evaluated for children younger than 15 years of age from 1996 to 2010, including 4 857 736 child-years of observation. Radiation doses were calculated for 744 CT scans performed between 2001 and 2011. Main Outcomes and Measures Rates of CT use, organ and effective doses, and projected lifetime attributable risks of cancer. Results The use of CT doubled for children younger than 5 years of age and tripled for children 5 to 14 years of age between 1996 and 2005, remained stable between 2006 and 2007, and then began to decline. Effective doses varied from 0.03 to 69.2 mSv per scan. An effective dose of 20 mSv or higher was delivered by 14% to 25% of abdomen/pelvis scans, 6% to 14% of spine scans, and 3% to 8% of chest scans. Projected lifetime attributable risks of solid cancer were higher for younger patients and girls than for older patients and boys, and they were also higher for patients who underwent CT scans of the abdomen/pelvis or spine than for patients who underwent other types of CT scans. For girls, a radiation-induced solid cancer is projected to result from every 300 to 390 abdomen/pelvis scans, 330 to 480 chest scans, and 270 to 800 spine scans, depending on age. The risk of leukemia was highest from head scans for children younger than 5 years of age at a rate of 1.9 cases per 10 000 CT scans. Nationally, 4 million pediatric CT scans of the head, abdomen/pelvis, chest, or spine performed each year are projected to cause 4870 future cancers. Reducing the highest 25% of doses to the median might prevent 43% of these cancers. Conclusions and Relevance The increased use of CT in pediatrics, combined with the wide variability in radiation doses, has resulted in many children receiving a high-dose examination. Dose-reduction strategies targeted to the highest quartile of doses could dramatically reduce the number of radiation-induced cancers.
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