NEJM：非必要不做CT！10%的儿童血癌与CT等医疗影像辐射有关

Core Viewpoint - The article discusses the association between radiation exposure from medical imaging, particularly CT scans, and the increased risk of hematologic cancers in children and adolescents, emphasizing the need for safer and more judicious use of imaging technologies [3][11]. Summary by Sections Medical Imaging and Cancer Risk - A large cohort study published in NEJM indicates that approximately 10.1% of hematologic cancer cases in children and adolescents can be attributed to radiation from medical imaging, primarily from CT scans [3][11]. - The study highlights the importance of balancing the benefits of medical imaging with the potential risks associated with radiation exposure [3]. Study Details - The research tracked 3,724,623 children born between 1996 and 2016 across six healthcare systems in the U.S. and Ontario, Canada, with a follow-up period averaging 10.1 years [6]. - During the follow-up, 2,961 cases of hematologic cancers were diagnosed, with a significant correlation found between cumulative radiation exposure and cancer risk [6][11]. Radiation Exposure and Cancer Incidence - The average radiation exposure for children diagnosed with hematologic cancers was 24.5±36.4 mGy, with a notable increase in cancer risk corresponding to higher cumulative doses [7]. - Relative risks (RR) for different radiation exposure levels were reported: - 1-5 mGy: RR of 1.41 - 15-20 mGy: RR of 1.82 - 50-100 mGy: RR of 3.59 - Each additional 100 mGy increases the excess relative risk by 2.54 [7][11]. Related Research - A study published in JAMA Internal Medicine projected that CT scans could account for 5% of cancer cases annually, with infants being the most affected demographic [12]. - Another study in Nature Medicine found that for every 100 mGy of radiation, the risk of developing hematologic malignancies doubles, with typical CT scans increasing the risk of lymphatic or myeloid malignancies by approximately 16% [13]. Conclusion - The findings underscore the necessity for healthcare providers to minimize unnecessary CT scans and radiation exposure while recognizing the life-saving potential of these imaging techniques [12][13].