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.
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.
Authors: Harvey O Coxson; Brendan Quiney; Don D Sin; Li Xing; Annette M McWilliams; John R Mayo; Stephen Lam Journal: Am J Respir Crit Care Med Date: 2008-02-28 Impact factor: 21.405
Authors: Choonsik Lee; Kwang Pyo Kim; Daniel Long; Ryan Fisher; Chris Tien; Steven L Simon; Andre Bouville; Wesley E Bolch Journal: Med Phys Date: 2011-03 Impact factor: 4.071
Authors: Sirisha Jonnalagadda; Cara Bergamo; Jenny J Lin; Linda Lurslurchachai; Michael Diefenbach; Cardinale Smith; Judith E Nelson; Juan P Wisnivesky Journal: Lung Cancer Date: 2012-06-06 Impact factor: 5.705
Authors: Shannon J Simpson; Lauren S Mott; Charles R Esther; Stephen M Stick; Graham L Hall Journal: Expert Rev Respir Med Date: 2013-06 Impact factor: 3.772