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Study Links X-rays, Thyroid Cancer—Maybe

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Thyroid cancer risk goes up as the number of dental X-rays increases, suggests a new study—though the study’s authors suggest viewing its results with caution.

Scientists from England and Kuwait compared 313 thyroid-cancer patients in Kuwait with a similar number of Kuwaitis without thyroid cancer, matched in terms of age, gender, nationality, and area of residence. The researchers found that “exposure to dental X-rays was significantly associated with an increased risk of thyroid cancer” and that “the association did not vary appreciably by age, gender, nationality, level of education, or parity.” The study has been published in the journal Acta Oncologica.

Though this is the largest case-control study on the subject, it relied on self-reporting by its participants, not actual dental X-ray records. Therefore, the study’s authors said, more research is needed.

“It is important that our study is repeated with information from dental records,” said Anjum Memon, MBBS, DPhil, leader of the researchers. “If the results are confirmed, then the use of X-rays as a necessary part of evaluation for new patients and routine periodic dental radiography (at 6–12 months’ interval), particularly for children and adolescents, will need to be reconsidered, as will a greater use of lead-collar protection.”

Dr. Memon is a senior lecturer and consultant in public health at Brighton and Sussex Medical School in England. He said the findings were consistent with reports of increased thyroid-cancer risk in dentists, dental assistants, and X-ray workers.

“The public-health and clinical implications of these findings are particularly relevant in the light of increases in the incidence of thyroid cancer in many countries over the past 30 years,” said Dr. Memon. Brighton and Sussex Medical School said the rate of thyroid-cancer cases more than doubled in Great Britain between 1975 and 2006, from 1.4 to 2.9 per 100,000 persons. In the United States, according to the National Cancer Institute, the rate increased from 1997 to 2007 by an annual average of 6.3%, to 10.2 per 100,000 persons.

“Our study highlights the concern that, like chest (or other upper-body) X-rays, dental X-rays should be prescribed when the patient has a specific clinical need and not as part of routine checkup or when registering with a dentist,” Dr. Memon said.

Related seminar: Diagnostic Imaging Review: For Residents, Fellows and Radiologists

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