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Diagnostic X-rays and risk of childhood leukaemia.
Int J Epidemiol. 2010 Dec; 39(6):1628-37.IJ

Abstract

BACKGROUND

The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear.

METHODS

This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n = 711) or acute myeloid leukaemia (AML, n = 116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal).

RESULTS

After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR) = 1.85, 95% confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR = 1.40, 95% CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR = 1.05, 95% CI 0.90-1.22) or T-cell ALL (OR = 0.84, 95% CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed.

CONCLUSIONS

The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation.

Authors+Show Affiliations

School of Public Health, University of California, Berkeley, CA, USA. kbartley@berkeley.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20889538

Citation

Bartley, Karen, et al. "Diagnostic X-rays and Risk of Childhood Leukaemia." International Journal of Epidemiology, vol. 39, no. 6, 2010, pp. 1628-37.
Bartley K, Metayer C, Selvin S, et al. Diagnostic X-rays and risk of childhood leukaemia. Int J Epidemiol. 2010;39(6):1628-37.
Bartley, K., Metayer, C., Selvin, S., Ducore, J., & Buffler, P. (2010). Diagnostic X-rays and risk of childhood leukaemia. International Journal of Epidemiology, 39(6), 1628-37. https://doi.org/10.1093/ije/dyq162
Bartley K, et al. Diagnostic X-rays and Risk of Childhood Leukaemia. Int J Epidemiol. 2010;39(6):1628-37. PubMed PMID: 20889538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic X-rays and risk of childhood leukaemia. AU - Bartley,Karen, AU - Metayer,Catherine, AU - Selvin,Steve, AU - Ducore,Jonathan, AU - Buffler,Patricia, Y1 - 2010/10/01/ PY - 2010/10/5/entrez PY - 2010/10/5/pubmed PY - 2011/9/9/medline SP - 1628 EP - 37 JF - International journal of epidemiology JO - Int J Epidemiol VL - 39 IS - 6 N2 - BACKGROUND: The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear. METHODS: This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n = 711) or acute myeloid leukaemia (AML, n = 116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal). RESULTS: After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR) = 1.85, 95% confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR = 1.40, 95% CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR = 1.05, 95% CI 0.90-1.22) or T-cell ALL (OR = 0.84, 95% CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed. CONCLUSIONS: The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/20889538/Diagnostic_X_rays_and_risk_of_childhood_leukaemia_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyq162 DB - PRIME DP - Unbound Medicine ER -