| TITLE: | Risk of childhood cancer from fetal irradiation [see comments] | ||||||
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| AUTHORS: | Doll R; Wakeford R | ||||||
| AUTHOR AFFILIATION: | Imperial Cancer Research Fund Cancer Studies Unit, Radcliffe Infirmary, Oxford, UK. | ||||||
| SOURCE: | Br J Radiol 1997 Feb;70:130-9 | ||||||
| CITATION IDS: | PMID: 9135438 UI: 97281130 | ||||||
| COMMENT: | Comment in: Br J Radiol 1997 Jul;70(835):769-70; discussion 771 Comment in: Br J Radiol 1997 Jul;70(835):770-1 Comment in: Br J Radiol 1998 Apr;71(844):460-1 | ||||||
| ABSTRACT: | The association between the low dose of ionizing radiation received by the fetus in utero from diagnostic radiography, particularly in the last trimester of pregnancy, and the subsequent risk of cancer in childhood provides direct evidence against the existence of a threshold dose below which no excess risk arises, and has led to changes in medical practice. Initially reported in 1956, a consistent association has been found in many case-control studies in different countries. The excess relative risk obtained from combining the results of these studies has high statistical significance and suggests that, in the past, a radiographic examination of the abdomen of a pregnant woman produced a proportional increase in risk of about 40%. A corresponding causal relationship is not universally accepted and this interpretation has been challenged on four grounds. On review, the evidence against bias and confounding as alternative explanations for the association is strong. Scrutiny of the objections to causality suggests that they are not, or may not be, valid. A causal explanation is supported by evidence indicating an appropriate dose-response relationship and by animal experiments. It is concluded that radiation doses of the order of 10 mGy received by the fetus in utero produce a consequent increase in the risk of childhood cancer. The excess absolute risk coefficient at this level of exposure is approximately 6% per gray, although the exact value of this risk coefficient remains uncertain. | ||||||
| MAIN MESH HEADINGS: | Neoplasms, Radiation-Induced/*epidemiology *Prenatal Exposure Delayed Effects | ||||||
| ADDITIONAL MESH HEADINGS: | Adolescence Bone Neoplasms/epidemiology Bone Neoplasms/etiology Central Nervous System Neoplasms/epidemiology Central Nervous System Neoplasms/etiology Child Child, Preschool Confidence Intervals Female Human Infant Infant, Newborn Leukemia, Radiation-Induced/epidemiology Lymphoma/epidemiology Lymphoma/etiology Neuroblastoma/epidemiology Neuroblastoma/etiology Pregnancy Pregnancy Trimester, Third Radiation Dosage Risk Factors | ||||||
| PUBLICATION TYPES: | JOURNAL ARTICLE REVIEW REVIEW, ACADEMIC | ||||||
| LANGUAGES: | Eng | ||||||