Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions
Background: We previously reported evidence of a dose–response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these find...
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| Veröffentlicht in: | British journal of cancer 2016-02, Vol.114 (4), p.388-394 |
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| creator | de Gonzalez, Amy Berrington Salotti, Jane A McHugh, Kieran Little, Mark P Harbron, Richard W Lee, Choonsik Ntowe, Estelle Braganza, Melissa Z Parker, Louise Rajaraman, Preetha Stiller, Charles Stewart, Douglas R Craft, Alan W Pearce, Mark S |
| description | Background:
We previously reported evidence of a dose–response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these findings.
Methods:
We collected and reviewed additional clinical information from radiology information systems (RIS) databases, underlying cause of death and pathology reports. We conducted sensitivity analyses excluding participants with cancer-predisposing conditions or previous unreported cancers and compared the dose–response analyses with our original results.
Results:
We obtained information from the RIS and death certificates for about 40% of the cohort (n∼180 000) and found cancer-predisposing conditions in 4 out of 74 leukaemia/myelodysplastic syndrome (MDS) cases and 13 out of 135 brain tumour cases. As these conditions were unrelated to CT exposure, exclusion of these participants did not alter the dose–response relationships. We found evidence of previous unreported cancers in 2 leukaemia/MDS cases, 7 brain tumour cases and 232 in non-cases. These previous cancers were related to increased number of CTs. Exclusion of these cancers reduced the excess relative risk per mGy by 15% from 0.036 to 0.033 for leukaemia/MDS (
P
-trend=0.02) and by 30% from 0.023 to 0.016 (
P
-trend |
| doi_str_mv | 10.1038/bjc.2015.415 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4815765</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3954784111</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-85bf71e141b3504965027ffc51834c2ce0a0e04462ac52671ffdf699e391bfab3</originalsourceid><addsrcrecordid>eNptkU-LFDEQxYMo7rh68ywBLx7sMUl3OmkPCzL4DxYEWc8hna7MZLY73aa6lf0SfmYzM-uyiqeiqB-vXtUj5Dlna85K_abdu7VgXK4rLh-QFZelKLgW6iFZMcZUwRrBzsgTxH1uG6bVY3Imaq0Fq6sV-fUVejuHMeIuTLSF-SdApJOFLtg5BUc3VxSdjUht7CguLcL3BeJMU8BrOnraw3JtYQj2CLTJhkjnZRiXhG-pRQTE4cBndN4BDcNk3bFbYgepvwlxS90Yu3A08ZQ88rZHeHZbz8m3D--vNp-Kyy8fP2_eXRau0uVcaNl6xYFXvC0lq5paMqG8d5LrsnLCAbMMWFXVwjopasW973zdNFA2vPW2Lc_JxUl3WtoBOpcdJtubKYXBphsz2mD-nsSwM9vxh6k0l6qWWeDVrUAa80NwNkNAB31vI4wLGq6V0EI2Qmf05T_oPn8n5vMMz1JSsVLxTL0-US6NiAn8nRnOzCFok4M2h6BNDjrjL-4fcAf_STYDxQnAPIpbSPe2_k_wN2usthY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1765570371</pqid></control><display><type>article</type><title>Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions</title><source>MEDLINE</source><source>Nature</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>de Gonzalez, Amy Berrington ; Salotti, Jane A ; McHugh, Kieran ; Little, Mark P ; Harbron, Richard W ; Lee, Choonsik ; Ntowe, Estelle ; Braganza, Melissa Z ; Parker, Louise ; Rajaraman, Preetha ; Stiller, Charles ; Stewart, Douglas R ; Craft, Alan W ; Pearce, Mark S</creator><creatorcontrib>de Gonzalez, Amy Berrington ; Salotti, Jane A ; McHugh, Kieran ; Little, Mark P ; Harbron, Richard W ; Lee, Choonsik ; Ntowe, Estelle ; Braganza, Melissa Z ; Parker, Louise ; Rajaraman, Preetha ; Stiller, Charles ; Stewart, Douglas R ; Craft, Alan W ; Pearce, Mark S</creatorcontrib><description>Background:
We previously reported evidence of a dose–response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these findings.
Methods:
We collected and reviewed additional clinical information from radiology information systems (RIS) databases, underlying cause of death and pathology reports. We conducted sensitivity analyses excluding participants with cancer-predisposing conditions or previous unreported cancers and compared the dose–response analyses with our original results.
Results:
We obtained information from the RIS and death certificates for about 40% of the cohort (n∼180 000) and found cancer-predisposing conditions in 4 out of 74 leukaemia/myelodysplastic syndrome (MDS) cases and 13 out of 135 brain tumour cases. As these conditions were unrelated to CT exposure, exclusion of these participants did not alter the dose–response relationships. We found evidence of previous unreported cancers in 2 leukaemia/MDS cases, 7 brain tumour cases and 232 in non-cases. These previous cancers were related to increased number of CTs. Exclusion of these cancers reduced the excess relative risk per mGy by 15% from 0.036 to 0.033 for leukaemia/MDS (
P
-trend=0.02) and by 30% from 0.023 to 0.016 (
P
-trend<0.0001) for brain tumours. When we included pathology reports we had additional clinical information for 90% of the cases. Additional exclusions from these reports further reduced the risk estimates, but this sensitivity analysis may have underestimated risks as reports were only available for cases.
Conclusions:
Although there was evidence of some bias in our original risk estimates, re-analysis of the cohort with additional clinical data still showed an increased cancer risk after low-dose radiation exposure from CT scans in young patients.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2015.415</identifier><identifier>PMID: 26882064</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/4028/67/1922 ; 692/4028/67/1990/283 ; 692/700/1421/1846/2771 ; 692/700/1750 ; Adolescent ; Adult ; Biomedical and Life Sciences ; Biomedicine ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - epidemiology ; Brain Neoplasms - etiology ; Cancer Research ; Child ; Clinical Study ; Cohort Studies ; Drug Resistance ; Epidemiology ; Female ; Humans ; Leukemia - diagnostic imaging ; Leukemia - epidemiology ; Leukemia - etiology ; Male ; Molecular Medicine ; Neoplasms, Radiation-Induced - diagnostic imaging ; Neoplasms, Radiation-Induced - epidemiology ; Neoplasms, Radiation-Induced - etiology ; Oncology ; Retrospective Studies ; Tomography, X-Ray Computed - adverse effects ; Tomography, X-Ray Computed - statistics & numerical data ; Young Adult</subject><ispartof>British journal of cancer, 2016-02, Vol.114 (4), p.388-394</ispartof><rights>The Author(s) 2016</rights><rights>Copyright Nature Publishing Group Feb 16, 2016</rights><rights>Copyright © 2016 Cancer Research UK 2016 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-85bf71e141b3504965027ffc51834c2ce0a0e04462ac52671ffdf699e391bfab3</citedby><cites>FETCH-LOGICAL-c483t-85bf71e141b3504965027ffc51834c2ce0a0e04462ac52671ffdf699e391bfab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815765/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815765/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26882064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Gonzalez, Amy Berrington</creatorcontrib><creatorcontrib>Salotti, Jane A</creatorcontrib><creatorcontrib>McHugh, Kieran</creatorcontrib><creatorcontrib>Little, Mark P</creatorcontrib><creatorcontrib>Harbron, Richard W</creatorcontrib><creatorcontrib>Lee, Choonsik</creatorcontrib><creatorcontrib>Ntowe, Estelle</creatorcontrib><creatorcontrib>Braganza, Melissa Z</creatorcontrib><creatorcontrib>Parker, Louise</creatorcontrib><creatorcontrib>Rajaraman, Preetha</creatorcontrib><creatorcontrib>Stiller, Charles</creatorcontrib><creatorcontrib>Stewart, Douglas R</creatorcontrib><creatorcontrib>Craft, Alan W</creatorcontrib><creatorcontrib>Pearce, Mark S</creatorcontrib><title>Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background:
We previously reported evidence of a dose–response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these findings.
Methods:
We collected and reviewed additional clinical information from radiology information systems (RIS) databases, underlying cause of death and pathology reports. We conducted sensitivity analyses excluding participants with cancer-predisposing conditions or previous unreported cancers and compared the dose–response analyses with our original results.
Results:
We obtained information from the RIS and death certificates for about 40% of the cohort (n∼180 000) and found cancer-predisposing conditions in 4 out of 74 leukaemia/myelodysplastic syndrome (MDS) cases and 13 out of 135 brain tumour cases. As these conditions were unrelated to CT exposure, exclusion of these participants did not alter the dose–response relationships. We found evidence of previous unreported cancers in 2 leukaemia/MDS cases, 7 brain tumour cases and 232 in non-cases. These previous cancers were related to increased number of CTs. Exclusion of these cancers reduced the excess relative risk per mGy by 15% from 0.036 to 0.033 for leukaemia/MDS (
P
-trend=0.02) and by 30% from 0.023 to 0.016 (
P
-trend<0.0001) for brain tumours. When we included pathology reports we had additional clinical information for 90% of the cases. Additional exclusions from these reports further reduced the risk estimates, but this sensitivity analysis may have underestimated risks as reports were only available for cases.
Conclusions:
Although there was evidence of some bias in our original risk estimates, re-analysis of the cohort with additional clinical data still showed an increased cancer risk after low-dose radiation exposure from CT scans in young patients.</description><subject>692/4028/67/1922</subject><subject>692/4028/67/1990/283</subject><subject>692/700/1421/1846/2771</subject><subject>692/700/1750</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - epidemiology</subject><subject>Brain Neoplasms - etiology</subject><subject>Cancer Research</subject><subject>Child</subject><subject>Clinical Study</subject><subject>Cohort Studies</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Leukemia - diagnostic imaging</subject><subject>Leukemia - epidemiology</subject><subject>Leukemia - etiology</subject><subject>Male</subject><subject>Molecular Medicine</subject><subject>Neoplasms, Radiation-Induced - diagnostic imaging</subject><subject>Neoplasms, Radiation-Induced - epidemiology</subject><subject>Neoplasms, Radiation-Induced - etiology</subject><subject>Oncology</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed - adverse effects</subject><subject>Tomography, X-Ray Computed - statistics & numerical data</subject><subject>Young Adult</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkU-LFDEQxYMo7rh68ywBLx7sMUl3OmkPCzL4DxYEWc8hna7MZLY73aa6lf0SfmYzM-uyiqeiqB-vXtUj5Dlna85K_abdu7VgXK4rLh-QFZelKLgW6iFZMcZUwRrBzsgTxH1uG6bVY3Imaq0Fq6sV-fUVejuHMeIuTLSF-SdApJOFLtg5BUc3VxSdjUht7CguLcL3BeJMU8BrOnraw3JtYQj2CLTJhkjnZRiXhG-pRQTE4cBndN4BDcNk3bFbYgepvwlxS90Yu3A08ZQ88rZHeHZbz8m3D--vNp-Kyy8fP2_eXRau0uVcaNl6xYFXvC0lq5paMqG8d5LrsnLCAbMMWFXVwjopasW973zdNFA2vPW2Lc_JxUl3WtoBOpcdJtubKYXBphsz2mD-nsSwM9vxh6k0l6qWWeDVrUAa80NwNkNAB31vI4wLGq6V0EI2Qmf05T_oPn8n5vMMz1JSsVLxTL0-US6NiAn8nRnOzCFok4M2h6BNDjrjL-4fcAf_STYDxQnAPIpbSPe2_k_wN2usthY</recordid><startdate>20160216</startdate><enddate>20160216</enddate><creator>de Gonzalez, Amy Berrington</creator><creator>Salotti, Jane A</creator><creator>McHugh, Kieran</creator><creator>Little, Mark P</creator><creator>Harbron, Richard W</creator><creator>Lee, Choonsik</creator><creator>Ntowe, Estelle</creator><creator>Braganza, Melissa Z</creator><creator>Parker, Louise</creator><creator>Rajaraman, Preetha</creator><creator>Stiller, Charles</creator><creator>Stewart, Douglas R</creator><creator>Craft, Alan W</creator><creator>Pearce, Mark S</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20160216</creationdate><title>Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions</title><author>de Gonzalez, Amy Berrington ; Salotti, Jane A ; McHugh, Kieran ; Little, Mark P ; Harbron, Richard W ; Lee, Choonsik ; Ntowe, Estelle ; Braganza, Melissa Z ; Parker, Louise ; Rajaraman, Preetha ; Stiller, Charles ; Stewart, Douglas R ; Craft, Alan W ; Pearce, Mark S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-85bf71e141b3504965027ffc51834c2ce0a0e04462ac52671ffdf699e391bfab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>692/4028/67/1922</topic><topic>692/4028/67/1990/283</topic><topic>692/700/1421/1846/2771</topic><topic>692/700/1750</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - epidemiology</topic><topic>Brain Neoplasms - etiology</topic><topic>Cancer Research</topic><topic>Child</topic><topic>Clinical Study</topic><topic>Cohort Studies</topic><topic>Drug Resistance</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Leukemia - diagnostic imaging</topic><topic>Leukemia - epidemiology</topic><topic>Leukemia - etiology</topic><topic>Male</topic><topic>Molecular Medicine</topic><topic>Neoplasms, Radiation-Induced - diagnostic imaging</topic><topic>Neoplasms, Radiation-Induced - epidemiology</topic><topic>Neoplasms, Radiation-Induced - etiology</topic><topic>Oncology</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed - adverse effects</topic><topic>Tomography, X-Ray Computed - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Gonzalez, Amy Berrington</creatorcontrib><creatorcontrib>Salotti, Jane A</creatorcontrib><creatorcontrib>McHugh, Kieran</creatorcontrib><creatorcontrib>Little, Mark P</creatorcontrib><creatorcontrib>Harbron, Richard W</creatorcontrib><creatorcontrib>Lee, Choonsik</creatorcontrib><creatorcontrib>Ntowe, Estelle</creatorcontrib><creatorcontrib>Braganza, Melissa Z</creatorcontrib><creatorcontrib>Parker, Louise</creatorcontrib><creatorcontrib>Rajaraman, Preetha</creatorcontrib><creatorcontrib>Stiller, Charles</creatorcontrib><creatorcontrib>Stewart, Douglas R</creatorcontrib><creatorcontrib>Craft, Alan W</creatorcontrib><creatorcontrib>Pearce, Mark S</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health 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USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Gonzalez, Amy Berrington</au><au>Salotti, Jane A</au><au>McHugh, Kieran</au><au>Little, Mark P</au><au>Harbron, Richard W</au><au>Lee, Choonsik</au><au>Ntowe, Estelle</au><au>Braganza, Melissa Z</au><au>Parker, Louise</au><au>Rajaraman, Preetha</au><au>Stiller, Charles</au><au>Stewart, Douglas R</au><au>Craft, Alan W</au><au>Pearce, Mark S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2016-02-16</date><risdate>2016</risdate><volume>114</volume><issue>4</issue><spage>388</spage><epage>394</epage><pages>388-394</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><coden>BJCAAI</coden><abstract>Background:
We previously reported evidence of a dose–response relationship between ionising-radiation exposure from paediatric computed tomography (CT) scans and the risk of leukaemia and brain tumours in a large UK cohort. Underlying unreported conditions could have introduced bias into these findings.
Methods:
We collected and reviewed additional clinical information from radiology information systems (RIS) databases, underlying cause of death and pathology reports. We conducted sensitivity analyses excluding participants with cancer-predisposing conditions or previous unreported cancers and compared the dose–response analyses with our original results.
Results:
We obtained information from the RIS and death certificates for about 40% of the cohort (n∼180 000) and found cancer-predisposing conditions in 4 out of 74 leukaemia/myelodysplastic syndrome (MDS) cases and 13 out of 135 brain tumour cases. As these conditions were unrelated to CT exposure, exclusion of these participants did not alter the dose–response relationships. We found evidence of previous unreported cancers in 2 leukaemia/MDS cases, 7 brain tumour cases and 232 in non-cases. These previous cancers were related to increased number of CTs. Exclusion of these cancers reduced the excess relative risk per mGy by 15% from 0.036 to 0.033 for leukaemia/MDS (
P
-trend=0.02) and by 30% from 0.023 to 0.016 (
P
-trend<0.0001) for brain tumours. When we included pathology reports we had additional clinical information for 90% of the cases. Additional exclusions from these reports further reduced the risk estimates, but this sensitivity analysis may have underestimated risks as reports were only available for cases.
Conclusions:
Although there was evidence of some bias in our original risk estimates, re-analysis of the cohort with additional clinical data still showed an increased cancer risk after low-dose radiation exposure from CT scans in young patients.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>26882064</pmid><doi>10.1038/bjc.2015.415</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-0920 |
| ispartof | British journal of cancer, 2016-02, Vol.114 (4), p.388-394 |
| issn | 0007-0920 1532-1827 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4815765 |
| source | MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | 692/4028/67/1922 692/4028/67/1990/283 692/700/1421/1846/2771 692/700/1750 Adolescent Adult Biomedical and Life Sciences Biomedicine Brain Neoplasms - diagnostic imaging Brain Neoplasms - epidemiology Brain Neoplasms - etiology Cancer Research Child Clinical Study Cohort Studies Drug Resistance Epidemiology Female Humans Leukemia - diagnostic imaging Leukemia - epidemiology Leukemia - etiology Male Molecular Medicine Neoplasms, Radiation-Induced - diagnostic imaging Neoplasms, Radiation-Induced - epidemiology Neoplasms, Radiation-Induced - etiology Oncology Retrospective Studies Tomography, X-Ray Computed - adverse effects Tomography, X-Ray Computed - statistics & numerical data Young Adult |
| title | Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions |
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