Research Reports - Lifetime risk of cancer from CT among patients surviving severe traumatic brain injury

AJR Am J Roentgenol. 2014 Feb;202(2):397-400

Salibi PN(1), Agarwal V, Panczykowski DM, Puccio AM, Sheetz MA, Okonkwo DO

OBJECTIVE. The purpose of this study was to determine the lifetime attributable
risk of cancer from CT among patients surviving severe traumatic brain injury.
MATERIALS AND METHODS. A retrospective cross-sectional study was conducted with
prospectively collected data on patients 16 years old and older admitted with a
Glasgow coma scale score of 8 or less to a single level 1 trauma center from 2007
to 2010. The effective dose of each CT examination the patients underwent was
predicted with literature-accepted effective dose values of standard helical CT
protocols. The lifetime attributable risk of cancer and related mortality
incurred as a result of CT were estimated with the cumulative effective dose
incurred from the time of injury to a 1-year follow-up evaluation and with the
approach established by the Biologic Effects of Ionizing Radiation VII report.
RESULTS. The average patient was a 34-year-old man. The median number of CT
examinations received during the first 12 months after injury was 20, and the
average cumulative effective dose was 87 ± 45 mSv. This resulted in increases in
the lifetime incidence of all cancer types from 45.5% to 46.3% and in the
lifetime incidence of cancer-related mortality from 22.1% to 22.5%. CONCLUSION.
Radiation exposure from the use of CT in the evaluation and management of severe
traumatic brain injury causes negligible increases in lifetime attributable risk
of cancer and cancer-related mortality. Treating physicians should not allow the
concern for future risk of radiation-induced cancer to influence decisions
regarding radiographic evaluation in the acute treatment of traumatic brain
injury.

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