Abstract

Background

Exposure to high doses of ionizing radiation is among the few well-established brain tumour risk factors. We used data from the Interphone study to evaluate the effects of exposure to low-dose radiation from diagnostic radiological examinations on glioma, meningioma and acoustic neuroma risk.

Methods

Brain tumour cases (2644 gliomas, 2236 meningiomas, 1083 neuromas) diagnosed in 2000–02 were identified through hospitals in 13 countries, and 6068 controls (population-based controls in most centres) were included in the analysis. Participation across all centres was 64% for glioma cases, 78% for meningioma cases, 82% for acoustic neuroma cases and 53% for controls. Information on previous diagnostic radiological examinations was obtained by interviews, including the frequency, timing and indication for the examinations. Typical brain doses per type of examination were estimated based on the literature. Examinations within the 5 years before the index date were excluded from the dose estimation. Adjusted odds ratios were estimated using conditional logistic regression.

Results

No materially or consistently increased odds ratios for glioma, meningioma or acoustic neuroma were found for any specific type of examination, including computed tomography of the head and cerebral angiography. The only indication of an elevated risk was an increasing trend in risk of meningioma with the number of isotope scans, but no such trends for other examinations were observed. No gradient was found in risk with estimated brain dose. Age at exposure did not substantially modify the findings. Sensitivity analyses gave results consistent with the main analysis.

Conclusions

There was no consistent evidence for increased risks of brain tumours with X-ray examinations, although error from selection and recall bias cannot be completely excluded. A cautious interpretation is warranted for the observed association between isotope scans and meningioma.

中文翻译：

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诊断放射学检查和成人颅内肿瘤的风险——对讲机研究的结果

 抽象的

 背景

暴露于高剂量电离辐射是少数几个已确定的脑肿瘤危险因素之一。我们使用 Interphone 研究的数据来评估诊断放射学检查中暴露于低剂量辐射对神经胶质瘤、脑膜瘤和听神经瘤风险的影响。

 方法

通过 13 个国家的医院确定了 2000-02 年诊断的脑肿瘤病例（2644 例神经胶质瘤、2236 例脑膜瘤、1083 例神经瘤），分析中纳入了 6068 例对照（大多数中心以人群为基础的对照）。所有中心的神经胶质瘤病例参与率为 64%，脑膜瘤病例参与率为 78%，听神经瘤病例参与率为 82%，对照病例参与率为 53%。有关先前诊断放射学检查的信息是通过访谈获得的，包括检查的频率、时间和适应症。根据文献估计每种检查类型的典型脑剂量。索引日期之前 5 年内的检查被排除在剂量估计之外。使用条件逻辑回归估计调整后的优势比。

 结果

对于任何特定类型的检查（包括头部计算机断层扫描和脑血管造影），没有发现神经胶质瘤、脑膜瘤或听神经瘤的比值比显着或持续增加。风险升高的唯一迹象是脑膜瘤风险随着同位素扫描次数的增加而增加，但其他检查没有观察到这种趋势。未发现估计脑剂量的风险存在梯度。暴露时的年龄并没有显着改变研究结果。敏感性分析得出的结果与主要分析一致。

 结论

尽管不能完全排除选择和回忆偏差造成的错误，但没有一致的证据表明 X 射线检查会增加脑肿瘤的风险。对于观察到的同位素扫描与脑膜瘤之间的关联，需要谨慎解释。