Diagnostic X-rays and risk of childhood leukaemia

Karen Bartley, Catherine Metayer, Steve Selvin, Jonathan M Ducore, Patricia Buffler

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background: The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear. Methods: This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n=711) or acute myeloid leukaemia (AML, n=116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal). Results: After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR)=1.85, 95% confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR=1.40, 95% CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR=1.05, 95% CI 0.90-1.22) or T-cell ALL (OR=0.84, 95% CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed. Conclusions: The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation. Published by Oxford University Press on behalf of the International Epidemiological Association

Original languageEnglish (US)
Article numberdyq162
Pages (from-to)1628-1637
Number of pages10
JournalInternational Journal of Epidemiology
Volume39
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Radiography
Leukemia
X-Rays
Odds Ratio
Confidence Intervals
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
Body Regions
Parturition
Precursor Cell Lymphoblastic Leukemia-Lymphoma
B-Lymphocytes
Mothers
T-Lymphocytes
Hispanic Americans
Acute Myeloid Leukemia
Registries
Case-Control Studies
Logistic Models
Regression Analysis
Pregnancy

Keywords

  • California
  • Childhood leukaemia
  • Diagnostic X-rays

ASJC Scopus subject areas

  • Epidemiology

Cite this

Bartley, K., Metayer, C., Selvin, S., Ducore, J. M., & Buffler, P. (2010). Diagnostic X-rays and risk of childhood leukaemia. International Journal of Epidemiology, 39(6), 1628-1637. [dyq162]. https://doi.org/10.1093/ije/dyq162

Diagnostic X-rays and risk of childhood leukaemia. / Bartley, Karen; Metayer, Catherine; Selvin, Steve; Ducore, Jonathan M; Buffler, Patricia.

In: International Journal of Epidemiology, Vol. 39, No. 6, dyq162, 12.2010, p. 1628-1637.

Research output: Contribution to journalArticle

Bartley, K, Metayer, C, Selvin, S, Ducore, JM & Buffler, P 2010, 'Diagnostic X-rays and risk of childhood leukaemia', International Journal of Epidemiology, vol. 39, no. 6, dyq162, pp. 1628-1637. https://doi.org/10.1093/ije/dyq162
Bartley, Karen ; Metayer, Catherine ; Selvin, Steve ; Ducore, Jonathan M ; Buffler, Patricia. / Diagnostic X-rays and risk of childhood leukaemia. In: International Journal of Epidemiology. 2010 ; Vol. 39, No. 6. pp. 1628-1637.
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abstract = "Background: The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear. Methods: This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n=711) or acute myeloid leukaemia (AML, n=116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal). Results: After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR)=1.85, 95{\%} confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR=1.40, 95{\%} CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR=1.05, 95{\%} CI 0.90-1.22) or T-cell ALL (OR=0.84, 95{\%} CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed. Conclusions: The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation. Published by Oxford University Press on behalf of the International Epidemiological Association",
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N2 - Background: The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear. Methods: This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n=711) or acute myeloid leukaemia (AML, n=116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal). Results: After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR)=1.85, 95% confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR=1.40, 95% CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR=1.05, 95% CI 0.90-1.22) or T-cell ALL (OR=0.84, 95% CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed. Conclusions: The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation. Published by Oxford University Press on behalf of the International Epidemiological Association

AB - Background: The association between diagnostic X-ray exposures early in life and increased risk of childhood leukaemia remains unclear. Methods: This case-control study included children aged 0-14 years diagnosed with acute lymphoid leukaemia (ALL, n=711) or acute myeloid leukaemia (AML, n=116) from 1995 to 2008. Controls were randomly selected from the California birth registry and individually matched to cases with respect to date of birth, sex, Hispanic ethnicity and maternal race. Conditional logistic regression analyses were performed to assess whether ALL or AML was associated with self-reported child's X-rays after birth (post-natal), including number of X-rays, region of the body X-rayed and age at first X-ray, as well as maternal X-rays before and during pregnancy (preconception and prenatal). Results: After excluding X-rays in the year prior to diagnosis (reference date for matched controls), risk of ALL was elevated in children exposed to three or more post-natal X-rays [odds ratio (OR)=1.85, 95% confidence interval (CI) 1.12-2.79]. For B-cell ALL specifically, any exposure (one or more X-rays) conferred increased risk (OR=1.40, 95% CI 1.06-1.86). Region of the body exposed was not an independent risk factor in multivariable analyses. No associations were observed between number of post-natal X-rays and AML (OR=1.05, 95% CI 0.90-1.22) or T-cell ALL (OR=0.84, 95% CI 0.59-1.19). Prevalence of exposure to prenatal and preconception X-rays was low, and no associations with ALL or AML were observed. Conclusions: The results suggest that exposure to post-natal diagnostic X-rays is associated with increased risk of childhood ALL, specifically B-cell ALL, but not AML or T-cell ALL. Given the imprecise measures of self-reported X-ray exposure, the results of this analysis should be interpreted with caution and warrant further investigation. Published by Oxford University Press on behalf of the International Epidemiological Association

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