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      Childhood cancer in the offspring born in 1921–1984 to US radiologic technologists

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          Abstract

          We examined the risk of childhood cancer (<20 years) among 105 950 offspring born in 1921–1984 to US radiologic technologist (USRT) cohort members. Parental occupational in utero and preconception ionising radiation (IR) testis or ovary doses were estimated from work history data, badge dose data, and literature doses (the latter doses before 1960). Female and male RTs reported a total of 111 and 34 haematopoietic malignancies and 115 and 34 solid tumours, respectively, in their offspring. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. Leukaemia ( n=63) and solid tumours ( n=115) in offspring were not associated with maternal in utero or preconception radiation exposure. Risks for lymphoma ( n=44) in those with estimated doses of <0.2, 0.2–1.0, and >1.0 mGy vs no exposure were non-significantly elevated with HRs of 2.3, 1.8, and 2.7. Paternal preconception exposure to estimated cumulative doses above the 95th percentile (⩾82 mGy, n=6 cases) was associated with a non-significant risk of childhood cancer of 1.8 (95% CI 0.7–4.6). In conclusion, we found no convincing evidence of an increased risk of childhood cancer in the offspring of RTs in association with parental occupational radiation exposure.

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              Risk of childhood cancer from fetal irradiation.

              The association between the low dose of ionizing radiation received by the fetus in utero from diagnostic radiography, particularly in the last trimester of pregnancy, and the subsequent risk of cancer in childhood provides direct evidence against the existence of a threshold dose below which no excess risk arises, and has led to changes in medical practice. Initially reported in 1956, a consistent association has been found in many case-control studies in different countries. The excess relative risk obtained from combining the results of these studies has high statistical significance and suggests that, in the past, a radiographic examination of the abdomen of a pregnant woman produced a proportional increase in risk of about 40%. A corresponding causal relationship is not universally accepted and this interpretation has been challenged on four grounds. On review, the evidence against bias and confounding as alternative explanations for the association is strong. Scrutiny of the objections to causality suggests that they are not, or may not be, valid. A causal explanation is supported by evidence indicating an appropriate dose-response relationship and by animal experiments. It is concluded that radiation doses of the order of 10 mGy received by the fetus in utero produce a consequent increase in the risk of childhood cancer. The excess absolute risk coefficient at this level of exposure is approximately 6% per gray, although the exact value of this risk coefficient remains uncertain.
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                Author and article information

                Journal
                Br J Cancer
                British Journal of Cancer
                Nature Publishing Group
                0007-0920
                1532-1827
                29 July 2008
                29 July 2008
                5 August 2008
                : 99
                : 3
                : 545-550
                Affiliations
                [1 ]Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota Minneapolis, MN 55455, USA
                [2 ]Division of Environmental Health Sciences, University of Minnesota Minneapolis, MN 55455, USA
                [3 ]Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD 20892, USA
                [4 ]University of Minnesota Cancer Center Minneapolis, MN 55455, USA
                [5 ]RTI Rockville, MD 20852, USA
                Author notes
                [* ]Author for correspondence: rossx014@ 123456umn.edu
                Article
                6604516
                10.1038/sj.bjc.6604516
                2527813
                18665174
                df887d41-1bdd-4005-9c00-0fe9db76624a
                Copyright 2008, Cancer Research UK
                History
                : 17 March 2008
                : 23 June 2008
                : 25 June 2008
                Categories
                Epidemiology

                Oncology & Radiotherapy
                risk factors,in utero,malignancy,preconception,aetiology,radiation
                Oncology & Radiotherapy
                risk factors, in utero, malignancy, preconception, aetiology, radiation

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