Published ahead of print on August 23, 2007, doi:10.1164/rccm.200704-591OC Am. J. Respir. Crit. Care Med., Volume 176, Number 10, November 2007, 970-973 A more recent version of this article appeared on November 15, 2007
Submitted on April 17, 2007 Radiation-induced Cancer Risk from Annual Computed Tomography for Patients with Cystic FibrosisAmy Berrington de Gonzalez1*,1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Insitute, Rockville, MD, USA * To whom correspondence should be addressed. 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. Objective: To estimate the risk of radiation-induced cancer from computed tomography for patients with cystic fibrosis, assuming annual monitoring starting at age 2 years. Methods: Radiation risk models (derived primarily from the study of the 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). 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. The estimated risks increased to 0.08% for males and 0.46% for females assuming median survival increases to age 50. 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. Conclusion: The cumulative risk of radiation-induced cancer from repeated lung CT scans for patients with cystic fibrosis is relatively small (<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
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