Childhood exposure to diagnostic X-ray ionizing radiation and leukemia risk

Abstract

IntroductionLeukemia is the most common cancer in children, and many studies have suggested a possible causal relationship with childhood exposure to x-ray ionizing radiation.ObjectiveTo assess the risk of developing leukemia in pediatric patients exposed to diagnostic x-ray ionizing radiation.Methods: A systematic review of the literature was conducted. Electronic databases searched included PubMed, EMBASE, Web of Science. We included peer-reviewed publications of cohort and case-control studies involving pediatric patients exposed to diagnostic x-ray ionizing radiation, evaluating the risk of these patients developing leukemia.Two reviewers analyzed the selected abstracts and full-text articles,performed data extraction,and evaluated the methodological quality of the selected articles.The methodological quality was assessed according to the Newcastle- Ottawa Scale. A meta-analysis was conducted using RevMan.ResultsOut of the 330 citations screened, 8 publications were included, representing 6,721 cases and 12,730 controls.All studies were designed as case-control.Age varied from 0 to 14 years,with a predominance of boys.The studies presented good methodological quality, but the results from individual studies were controversial.The summary of results demonstrated significant positive associations for being exposed to one or more, and three or more x-rays and the subsequent development of leukemia. No significant association was identified when considering four or more x-rays.