Réglementation française et contrôle de l'irradiation en tomodensitométrie chez l'enfant

[Diagnostic radiation exposure in children and cancer risk: current knowledge and perspectives]

The question of the risk of cancer associated with postnatal diagnostic medical exposure involving ionizing radiation in childhood is particularly relevant at the moment given the growing use of diagnostic examinations, especially computed tomography scans, in children. Compared to adults, pediatric patients are more sensitive to radiation and have more years of life expectancy and therefore more years at risk of cancer occurrence as compared to adults. This paper provides a description of diagnostic x-ray exposure in children in France and summarizes epidemiologic studies on subsequent risk of cancer. Overall, this review, based on 12 case-control studies and 6 cohort studies, shows no significant association between exposure to medical diagnostic radiation exposure and childhood cancer risk. The methodological limitations of these studies are discussed. As the expected cancer risks are low, epidemiological studies require very large sample sizes and long periods of follow-up in addition to a good dosimetry assessment to enable quantitative risk estimation. New cohort studies of young patients who underwent CT scans are currently underway within the European EPI-CT project. In the meantime, continued efforts to reduce doses and the number of radiological examinations in children are needed, including adhering to the "as long as reasonably achievable" (Alara) principle.