Cancer risk from pediatric diagnostic radiology; should we be concerned ?.

Abstract

Diagnostic radiology has an important role in pediatrics. Some imaging modalities give high radiation doses and there is a rising concern on the safety of radiation. This article aims to provide information on the increased risk of cancer from radiation used in diagnostic radiology. The information may help in the process of decision making in referring pediatric patients to CT and in communicating with their parents. Radiation doses in diagnostic radiology in pediatrics are mostly low, but some may reach the moderate level. From the recent knowledge, many believe that even a low-dose radiation has a certain risk of cancer development, the higher the dose the higher the risk. Increased cancer risk from CT scanning is between 1 in 10,000 and 1 in 2,000 while the risk from a chest X-ray is 1 in 1,000,000. The younger the patient, the higher is the risk. Underestimation of CT radiation risk by referring physicians was reported, and it might be an important cause of referring patients to CT scanning more than necessary. Radiologists and CT technologists in some centers had not lowered the radiation dose, particular in CT scanning, for children. International organizations have introduced “diagnostic reference levels” of many imaging modalities and requested every country to follow. On the other hand, we should know that all people receive natural background radiation plus other factors that may already cause a significant cancer risk which is much higher than the risk from medical radiation. The risk from radiation is not high when compared to overall risk from other causes to an individual, however, this should not be an excuse to add unnecessary medical radiation. Justification for imaging and properly performed imaging are essential.