Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study.
Medical diagnostic X-rays are an important source of ionizing radiation (IR) exposure in the general population; however, it is unclear if the resulting low patient doses increase lymphoma risk. We examined the association between lifetime medical diagnostic X-ray dose and lymphoma risk, taking into...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0235658 |
| _version_ | 1819017073846648832 |
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| author | Elisa Pasqual Michelle C Turner Esther Gracia-Lavedan Delphine Casabonne Yolanda Benavente Isabelle Thierry Chef Marc Maynadié Pierluigi Cocco Anthony Staines Lenka Foretova Alexandra Nieters Paolo Boffetta Paul Brennan Elisabeth Cardis Silvia de Sanjose |
| author_facet | Elisa Pasqual Michelle C Turner Esther Gracia-Lavedan Delphine Casabonne Yolanda Benavente Isabelle Thierry Chef Marc Maynadié Pierluigi Cocco Anthony Staines Lenka Foretova Alexandra Nieters Paolo Boffetta Paul Brennan Elisabeth Cardis Silvia de Sanjose |
| author_sort | Elisa Pasqual |
| collection | DOAJ |
| description | Medical diagnostic X-rays are an important source of ionizing radiation (IR) exposure in the general population; however, it is unclear if the resulting low patient doses increase lymphoma risk. We examined the association between lifetime medical diagnostic X-ray dose and lymphoma risk, taking into account potential confounding factors, including medical history. The international Epilymph study (conducted in the Czech-Republic, France, Germany, Ireland, Italy, and Spain) collected self-reported information on common diagnostic X-ray procedures from 2,362 lymphoma cases and 2,465 frequency-matched (age, sex, country) controls. Individual lifetime cumulative bone marrow (BM) dose was estimated using time period-based dose estimates for different procedures and body parts. The association between categories of BM dose and lymphoma risk was examined using unconditional logistic regression models adjusting for matching factors, socioeconomic variables, and the presence of underlying medical conditions (atopic, autoimmune, infectious diseases, osteoarthritis, having had a sick childhood, and family history of lymphoma) as potential confounders of the association. Cumulative BM dose was low (median 2.25 mGy) and was not positively associated with lymphoma risk. Odds ratios (ORs) were consistently less than 1.0 in all dose categories compared to the reference category (less than 1 mGy). Results were similar after adjustment for potential confounding factors, when using different exposure scenarios, and in analyses by lymphoma subtype and by type of control (hospital-, population-based). Overall no increased risk of lymphoma was observed. The reduced ORs may be related to unmeasured confounding or other sources of systematic bias.We found little evidence that chronic medical conditions confound lymphoma risk and medical radiation associations. |
| first_indexed | 2024-12-21T02:57:44Z |
| format | Article |
| id | doaj.art-15edfd0b2842473daaa89606d5437423 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T02:57:44Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-15edfd0b2842473daaa89606d54374232022-12-21T19:18:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01157e023565810.1371/journal.pone.0235658Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study.Elisa PasqualMichelle C TurnerEsther Gracia-LavedanDelphine CasabonneYolanda BenaventeIsabelle Thierry ChefMarc MaynadiéPierluigi CoccoAnthony StainesLenka ForetovaAlexandra NietersPaolo BoffettaPaul BrennanElisabeth CardisSilvia de SanjoseMedical diagnostic X-rays are an important source of ionizing radiation (IR) exposure in the general population; however, it is unclear if the resulting low patient doses increase lymphoma risk. We examined the association between lifetime medical diagnostic X-ray dose and lymphoma risk, taking into account potential confounding factors, including medical history. The international Epilymph study (conducted in the Czech-Republic, France, Germany, Ireland, Italy, and Spain) collected self-reported information on common diagnostic X-ray procedures from 2,362 lymphoma cases and 2,465 frequency-matched (age, sex, country) controls. Individual lifetime cumulative bone marrow (BM) dose was estimated using time period-based dose estimates for different procedures and body parts. The association between categories of BM dose and lymphoma risk was examined using unconditional logistic regression models adjusting for matching factors, socioeconomic variables, and the presence of underlying medical conditions (atopic, autoimmune, infectious diseases, osteoarthritis, having had a sick childhood, and family history of lymphoma) as potential confounders of the association. Cumulative BM dose was low (median 2.25 mGy) and was not positively associated with lymphoma risk. Odds ratios (ORs) were consistently less than 1.0 in all dose categories compared to the reference category (less than 1 mGy). Results were similar after adjustment for potential confounding factors, when using different exposure scenarios, and in analyses by lymphoma subtype and by type of control (hospital-, population-based). Overall no increased risk of lymphoma was observed. The reduced ORs may be related to unmeasured confounding or other sources of systematic bias.We found little evidence that chronic medical conditions confound lymphoma risk and medical radiation associations.https://doi.org/10.1371/journal.pone.0235658 |
| spellingShingle | Elisa Pasqual Michelle C Turner Esther Gracia-Lavedan Delphine Casabonne Yolanda Benavente Isabelle Thierry Chef Marc Maynadié Pierluigi Cocco Anthony Staines Lenka Foretova Alexandra Nieters Paolo Boffetta Paul Brennan Elisabeth Cardis Silvia de Sanjose Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. PLoS ONE |
| title | Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. |
| title_full | Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. |
| title_fullStr | Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. |
| title_full_unstemmed | Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. |
| title_short | Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. |
| title_sort | association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the epilymph case control study |
| url | https://doi.org/10.1371/journal.pone.0235658 |
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