Patterns of diagnostic imaging and associated radiation exposure among long-term survivors of young adult cancer: a population-based cohort study

BMC Cancer

Research Article

Wayne Deitel¹  Corinne Daly²  Nancy N. Baxter³  David R. Urbach⁴  Andrew S. Wilton⁵  Thérèse A. Stukel⁶  Lawrence F. Paszat⁷  Paul C. Nathan⁸ 

[1]Department of Radiology, St. Michael’s Hospital, Toronto, Canada

[2]Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

[3]Department of Surgery, Li Ki Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

[4]Institute for Clinical Evaluative Sciences, Toronto, Canada

[5]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

[6]Department of Surgery, University Health Network, Toronto, Canada

[7]Institute for Clinical Evaluative Sciences, Toronto, Canada

[8]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

[9]Institute for Clinical Evaluative Sciences, Toronto, Canada

[10]Institute for Clinical Evaluative Sciences, Toronto, Canada

[11]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

[12]Institute for Clinical Evaluative Sciences, Toronto, Canada

[13]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

[14]Department of Radiation Oncology, Sunnybrook Health Sciences Center, Toronto, Canada

[15]Institute for Clinical Evaluative Sciences, Toronto, Canada

[16]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

[17]Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada

关键词: Diagnostic Imaging;    Malignancy Type;    Ontario Health Insurance Plan;    Diagnostic Imaging Study;    Ontario Cancer Registry;   

DOI  :  10.1186/s12885-015-1578-1

 received in 2014-07-28, accepted in 2015-07-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSurvivors of young adult malignancies are at risk of accumulated exposures to radiation from repetitive diagnostic imaging. We designed a population-based cohort study to describe patterns of diagnostic imaging and cumulative diagnostic radiation exposure among survivors of young adult cancer during a survivorship time period where surveillance imaging is not typically warranted.MethodsYoung adults aged 20–44 diagnosed with invasive malignancy in Ontario from 1992–1999 who lived at least 5 years from diagnosis were identified using the Ontario Cancer Registry and matched 5 to 1 to randomly selected cancer-free persons. We determined receipt of 5 modalities of diagnostic imaging and associated radiation dose received by survivors and controls from years 5–15 after diagnosis or matched referent date through administrative data. Matched pairs were censored six months prior to evidence of recurrence.Results20,911 survivors and 104,524 controls had a median of 13.5 years observation. Survivors received all modalities of diagnostic imaging at significantly higher rates than controls. Survivors received CT at a 3.49-fold higher rate (95 % Confidence Interval [CI]:3.37, 3.62) than controls in years 5 to 15 after diagnosis. Survivors received a mean radiation dose of 26 miliSieverts solely from diagnostic imaging in the same time period, a 4.57-fold higher dose than matched controls (95 % CI: 4.39, 4.81).ConclusionsLong-term survivors of young adult cancer have a markedly higher rate of diagnostic imaging over time than matched controls, imaging associated with substantial radiation exposure, during a time period when surveillance is not routinely recommended.

【 授权许可】

CC BY   
© Daly et al. 2015