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Child X-rays May Increase Risk Of Leukemia

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Diagnostic X-rays of children may increase the risk that the children will develop leukemia, according to a new study by researchers at the School of Public Health at the University of California, Berkeley.

When the researchers examined the medical histories of children with acute lymphoid leukemia (ALL), they found that there was almost twice the chance that the children had been exposed to three or more X-rays compared to children who did not have leukemia. Even one X-ray moderately increased the risk for B-cell ALL.

The risk varied slightly depending on which region of the body had been X-rayed. Chest X-rays carried a small increase in risk.

The findings come from the Northern California Childhood Leukemia Study, a population-based, case-control study that includes 35 counties in Northern and Central California. The new findings were published in the October issue of the International Journal of Epidemiology.

The principal investigator for the Northern California Childhood Leukemia Study is Patricia Buffler, PhD, professor of epidemiology at UC Berkeley. A university news release quoted her as saying:

The general clinical impression has been that the level of radiation a child would be exposed to today from a conventional X-ray would not confer an additional risk for cancer. The results of our study were not what we expected.

The study included 827 children up to age 15 who had been diagnosed with either ALL or acute myeloid leukemia (AML). They were compared to other children randomly selected from the California birth registry and matched for age, gender, ethnicity, maternal race, and other factors.

Karen Bartley, lead author of the study and a doctoral student in epidemiology, said, “X-rays are a valuable tool, and our findings indicate that their use should continue to be judicious. Of greater concern, perhaps, is the use of newer imaging technologies, which are becoming more common and which produce far higher doses of radiation.”

In other words, CT.

Rebecca Smith-Bindman, MD, professor of radiology at the University of California, San Francisco, was not involved in the study but has been separately studying children exposed to ionizing radiation from CT scans. Dr. Smith-Bindman said:

The findings about increased leukemia risk certainly warrant further investigation. If even plain film X-rays are associated with an increased risk of leukemia, then one has to wonder about CT scans, some of which can generate 500 times the dose of radiation of an X-ray.

Dr. Smith-Bindman said that two-thirds of the imaging procedures that children undergo are conventional X-rays, which account for about 20 percent of their exposure to radiation from imaging. CT scans make up only 10 percent of children’s imaging tests, she said, but generate two-thirds of the children’s dosage of ionizing radiation.

Related seminar: Pediatric Radiology Review

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