The risk of cancer attributable to diagnostic medical radiation: Estimation for France in 2015

• Published in: International journal of cancer Vol. 144; no. 12; pp. 2954 - 2963
• Main Authors: Marant‐Micallef, Claire, Shield, Kevin D., Vignat, Jérôme, Cléro, Enora, Kesminiene, Ausrele, Hill, Catherine, Rogel, Agnès, Vacquier, Blandine, Bray, Freddie, Laurier, Dominique, Soerjomataram, Isabelle
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 15.06.2019; Wiley Subscription Services, Inc; Wiley
• Subjects: Adult; Age Factors; Aged; Biological effects; Cancer; Carcinogens; Colon; Diagnostic Imaging - adverse effects; Diagnostic Imaging - statistics & numerical data; diagnostic medical ionizing radiation; Exposure; Female; France - epidemiology; Health risk assessment; Health risks; Humans; Ionizing radiation; Latency; Life Sciences; Lungs; Male; Medical research; Middle Aged; Neoplasms, Radiation-Induced - epidemiology; Nuclear medicine; Optimization; population‐attributable fraction; Radiation Dosage; Radiation Exposure; Radiation, Ionizing; Radiology; Risk; Risk factors; Sex Factors; France; population-attributable fraction; cancer; risk; diagnostic medical ionizing radiation
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.32048

Although medical ionizing radiation (IR) has clear clinical benefits, it is an established carcinogen. Our study estimates the number of new cancer cases in France in 2015 attributable to IR exposure from medical procedures. Exposures from external (X‐rays, CT scans, interventional radiology) and internal (nuclear medicine) sources were considered. We used 2007 national frequencies of diagnostic examinations by sex and age to estimate the lifetime organ dose exposure adjusted for changes in the use of such procedures over time. The Biological Effects of Ionizing Radiation VII risk models were used to estimate the corresponding excess cancer risk, assuming an average latency period of 10 years. Additionally, we used cancer incidence data from the French Cancer Registries Network. Of the 346,000 estimated new cancer cases in adults in France in 2015, 2300 cases (940 among men and 1360 among women) were attributable to diagnostic IR, representing 0.7% of all new cancer cases (0.5% for men and 0.9% for women). The leading cancers attributable to medical IR were female breast (n = 560 cases), lung (n = 500 cases) and colon (n = 290 cases) cancers. Compared to other risk factors, the contribution of medical IR to the cancer burden is small, and the benefits largely outweigh its harms. However, some of these IR‐associated cancer cases may be preventable through dose optimization of and enhanced justification for diagnostic examinations. What's new? Radiation exposure from medical diagnostic procedures accounted for about 0.7% of cases in 2015, according to a French study. The chief culprit was external radiation, like X‐rays or CT scans, and the biggest increases occurred in leukemia and bladder cancer. They considered the frequency of diagnostic procedures, combined with the Biological Effects of Ionizing Radiation VII risk model, to estimate the resulting excess cancer risk from these procedures. While the authors acknowledge that the benefits of medical radiation exposure outweigh the risks, they point out that careful consideration of dosages and justifications for the procedures could prevent some cancers.