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Radiation-induced Cancer Risk from Annual Computed Tomography for Patients with Cystic Fibrosis

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and ² Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland

Correspondence and requests for reprints should be addressed to Amy Berrington de González, D.Phil., 615 N. Wolfe Street (E6136), Baltimore, MD 21205. E-mail: aberring{at}jhsph.edu

Rationale: Computed tomography (CT) is being considered as a tool for routine monitoring of lung damage in people with cystic fibrosis. Concern has been raised, however, about the associated risk of radiation-induced cancer.

Objectives: To estimate the risk of radiation-induced cancer from lung CT for patients with cystic fibrosis, assuming annual monitoring starting at age 2 years.

Methods: Radiation risk models (derived primarily from the study of Japanese atomic bomb survivors) were used to estimate the excess risk of radiation-induced cancer for the organs that receive measurable doses from lung CT. Two scenarios were considered: median survival to age 36 years (approximate current median survival) and median survival to age 50 years (projected median survival by 2030).

Measurements and Main Results: The estimated risk of radiation-induced cancer from annual lung CT was 0.02% for males and 0.07% for females assuming median survival to age 36 years. The estimated risks increased to 0.08% for males and 0.46% for females assuming median survival increases to age 50 years. The risks are higher for females because of the risk of radiation-induced breast cancer (50% of total risk) and higher risk of thyroid cancer.

Conclusions: The cumulative risk of radiation-induced cancer from repeated lung CT scans for patients with cystic fibrosis is relatively small (less than 0.5%). However, routine monitoring should not be recommended until there is a demonstrated benefit that will outweigh these risks.

Key Words: computed tomography • cancer • radiation • cystic fibrosis • risk

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Computed tomography (CT) is being considered as a tool for routine monitoring of lung function in patients with cystic fibrosis. Concern has been raised, however, about the associated risk of radiation-induced cancer from repeated CT scans. What This Study Adds to the Field The risk of radiation-induced cancer from repeated lung CT scans for patients with cystic fibrosis is much smaller than previous estimates suggested.

 

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