CT examination of children and the risk of cancer (EPI-CT)
Background & aims
It is likely that children and young individuals are more likely to experience negative impact on health after exposure to radiation as compared to adults. The reason for this is a higher sensitivity for effects of radiation and younger individuals have a longer life ahead of them during which the effects of radiation can manifest themselves.
Exams based on computerized tomography (CT) contribute to around 80% of the population’s radiation experienced from medical and diagnostic treatment. There is a large body of knowledge on how high doses of radiation may impact health for adults. Even if the total amount of radiations experienced is low, it is important to ensure that those that undergo medical exams are exposed to as little as possible radiation in these procedures.
Furthermore, it is important to investigate whether risks for health are associated with the use of low-dosage CT exams for children and young individuals. The Cancer Registry of Norway will therefore collaborate with The Norwegian Radiation and Nuclear Safety Authority (DSA) and Oslo University Hospital to analyze data from Norwegian hospitals regarding medical exams of 20 000 Norwegian children and individuals below the age of 20, collected during the timeframe 1985-2015. This cohort is part of a European study including 1.1 million individuals in the same age categories. The study will monitor whether the exposed groups has more diagnosis of leukemia, other cancers or other negative effects on health as compared to the general population for these age groups.
The analyses are performed through the coupling of the Norwegian Cause of Death Registry, the Cancer Registry of Norway and the Medical Birth Registry of Norway. Through these couplings one can monitor registered data on health. Over time, with the overall increase of risk for disease this study may be able to identify adverse effects of radiation during childhood and/or below the age of 20.
The results will contribute to optimize radiation dosages in CT and contribute to developing European and national recommendations for the use of CT for children.
Hauptmann M, Byrnes G, Cardis E, Bernier MO, Blettner M, Dabin J, Engels H, Istad TS, Johansen C, Kaijser M, Kjaerheim K, Journy N, Meulepas JM, Moissonnier M, Ronckers C, Thierry-Chef I, Le Cornet L, Jahnen A, Pokora R, Bosch de Basea M, Figuerola J, Maccia C, Nordenskjold A, Harbron RW, Lee C, Simon SL, Berrington de Gonzalez A, Schüz J, Kesminiene A. Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study. Lancet Oncol. 2023 Jan;24(1):45-53. doi: 10.1016/S1470-2045(22)00655-6. Epub 2022 Dec 6. PMID: 36493793.
Thierry-Chef I, Ferro G, Le Cornet L, Dabin J, Istad TS, Jahnen A, Lee C, Maccia C, Malchair F, Olerud HM, Harbron RW, Figuerola J, Hermen J, Moissonnier M, Bernier MO, Bosch de Basea MB, Byrnes G, Cardis E, Hauptmann M, Journy N, Kesminiene A, Meulepas JM, Pokora R, Simon SL. Dose Estimation for the European Epidemiological Study on Pediatric Computed Tomography (EPI-CT). Radiat Res. 2021 Jul 1;196(1):74-99. doi: 10.1667/RADE-20-00231.1. PMID: 33914893.
Bernier MO, Baysson H, Pearce MS, Moissonnier M, Cardis E, Hauptmann M, Struelens L, Dabin J, Johansen C, Journy N, Laurier D, Blettner M, Le Cornet L, Pokora R, Gradowska P, Meulepas JM, Kjaerheim K, Istad T, Olerud H, Sovik A, Bosch de Basea M, Thierry-Chef I, Kaijser M, Nordenskjöld A, Berrington de Gonzalez A, Harbron RW, Kesminiene A. Cohort Profile: the EPI-CT study: a European pooled epidemiological study to quantify the risk of radiation-induced cancer from paediatric CT. Int J Epidemiol. 2019 Apr 1;48(2):379-381g. doi: 10.1093/ije/dyy231. PMID: 30388267; PMCID: PMC6469297.
Bosch de Basea M, Pearce MS, Kesminiene A, Bernier MO, Dabin J, Engels H, Hauptmann M, Krille L, Meulepas JM, Struelens L, Baatout S, Kaijser M, Maccia C, Jahnen A, Thierry-Chef I, Blettner M, Johansen C, Kjaerheim K, Nordenskjöld A, Olerud H, Salotti JA, Andersen TV, Vrijheid M, Cardis E. EPI-CT: design, challenges and epidemiological methods of an international study on cancer risk after paediatric and young adult CT. J Radiol Prot. 2015 Sep;35(3):611-28. doi: 10.1088/0952-4746/35/3/611. Epub 2015 Jul 30. PMID: 26226081.
Thierry-Chef I, Dabin J, Friberg EG, Hermen J, Istad TS, Jahnen A, Krille L, Lee C, Maccia C, Nordenskjöld A, Olerud HM, Rani K, Rehel JL, Simon SL, Struelens L, Kesminiene A. Assessing organ doses from paediatric CT scans--a novel approach for an epidemiology study (the EPI-CT study). Int J Environ Res Public Health. 2013 Feb 18;10(2):717-28. doi: 10.3390/ijerph10020717. PMID: 23429160; PMCID: PMC3635173.
Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de González A. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012 Aug 4;380(9840):499-505. doi: 10.1016/S0140-6736(12)60815-0. Epub 2012 Jun 7. PMID: 22681860; PMCID: PMC3418594.
