Computed tomography in children: multicenter cohort study design for the evaluation of cancer risk

Krille, Lucian; Jahnen, Andréas; Mildenberger, P.; Schneider, K.; Weisser, G; Zeeb, Hajo; Blettner, Maria

doi:10.1007/s10654-011-9549-6

Cited by 19 publications

(14 citation statements)

References 3 publications

(3 reference statements)

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“…C'est dans ce contexte que s'inscrit la « Cohorte Enfant Scanner » en France . Des données similaires sont actuellement collectées en Grande-Bretagne (Pearce et al, 2012), en Allemagne (Krille et al, 2011) (HLEG, 2009). En s'intéres-sant aux expositions reçues dans l'enfance, notre projet de recherche permettra d'apporter des éléments de réponse sur la variabilité individuelle du risque de cancer, et en particulier sur l'effet de l'âge à l'exposition.…”

Section: Discussionunclassified

Suivi d’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique

Baysson¹,

Journy²,

Rehel³

et al. 2012

Radioprotection

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RÉSUMÉcancer registries and from mortality data. The "Cohort Child Scanner" consists of over 80 000 children and is part of the European project EPI-CT, which will gather data from 9 national cohorts. The cohort of children in interventional cardiology will include more than 8 000 children. These cohort studies, with extended follow-up, will contribute to the assessment of the health impact of radiation exposure received during childhood.

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Section: Discussionunclassified

Suivi d’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique

Baysson¹,

Journy²,

Rehel³

et al. 2012

Radioprotection

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“…100–102 Only one case-control study to date has published results on self-reported history of CT scans showing no increased risk of childhood ALL, based on small numbers of exposed children. 103 Recent cohort studies with access to medical data in Europe 101,104–106 , Australia 107 , and the US 102 , have reported small to moderate increases in the risk of leukemia in children exposed to CT scans; findings, however, were based on small number of excess cases ranging from 6 to 74. Pearce et al 106 conducted a retrospective cohort study of 178,604 UK children and young adults with CT scans from 1985 to 2002.…”

Section: Environmental Risk Factors For Childhood Leukemiamentioning

confidence: 99%

“…106 The main criticism of the study was the lack of an unexposed control group. Other cohort studies are underway 108 including a pooled European study (EPI-CT) 104 of about one million subjects (age 0–21 years). Although the number of excess childhood leukemia cases is still likely to be low (estimated to be approximately 60 to 100), this study will obtain more precise exposure information than previously possible, including individual doses of radiation for each organ.…”

Section: Environmental Risk Factors For Childhood Leukemiamentioning

confidence: 99%

Childhood Leukemia and Primary Prevention

Whitehead

Metayer

Wiemels

et al. 2016

Current Problems in Pediatric and Adolescent Health Care

106

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Leukemia is the most common pediatric cancer, affecting 3,800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia – usually before age five – and the presence at birth of “pre-leukemic” genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature – in the United States and internationally – that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the pre-conception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors – including pooled analyses from around the world and systematic reviews – is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children’s health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgement until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.

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“…Based on the results of the feasibility study, details for the main study were laid down, as mentioned previously in brief (Krille et al 2011b). Patients will be recruited in several major hospitals starting from the date when electronic data became available but not before 1980.…”

Section: Feasibility Studymentioning

confidence: 99%

Computed tomographies and cancer risk in children: a literature overview of CT practices, risk estimations and an epidemiologic cohort study proposal

Krille

Zeeb

Jahnen³

et al. 2012

Radiat Environ Biophys

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Radiation protection is a topic of great public concern and of many scientific investigations, because ionizing radiation is an established risk factor for leukaemia and many solid tumours. Exposure of the public to ionizing radiation includes exposure to background radiation, as well as medical and occupational exposures. A large fraction of the exposure from diagnostic procedures comes from medical imaging. Computed tomography (CT) is the major single contributor of diagnostic radiation exposure. An increase in the use of CTs has been reported over the last decades in many countries. Children have smaller bodies and lower shielding capacities, factors that affect the individual organ doses due to medical imaging. Several risk models have been applied to estimate the cancer burden caused by ionizing radiation from CT. All models predict higher risks for cancer among children exposed to CT as compared to adults. However, the cancer risk associated with CT has not been assessed directly in epidemiological studies. Here, plans are described to conduct an historical cohort study to investigate the cancer incidence in paediatric patients exposed to CT before the age of 15 in Germany. Patients will be recruited from radiology departments of several hospitals. Their individual exposure will be recorded, and time-dependent cumulative organ doses will be calculated. Follow-up for cancer incidence via the German Childhood Cancer Registry will allow computation of standardized incidence ratios using population-based incidence rates for childhood cancer. Dose-response modelling and analyses for subgroups of children based on the indication for and the result of the CT will be performed.

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Computed tomography in children: multicenter cohort study design for the evaluation of cancer risk

Cited by 19 publications

References 3 publications

Suivi d’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique

Suivi d’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique

Childhood Leukemia and Primary Prevention

Computed tomographies and cancer risk in children: a literature overview of CT practices, risk estimations and an epidemiologic cohort study proposal

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