Background
Methods
Protocol
Study types
Population
Interventions
Outcome measures
Search methods for identification of studies
Assessment of risk of bias (ROBs) in included studies
Dealing with missing data
Assessment of publication bias
Subgroup analysis
Sensitivity analysis
Assessment of heterogeneity
Results
Hallmarks of included studies
Participant hallmarks
Study | Country | Participants | Age (Y) | Gender (F/M) | Cancer Case | Participants/Cancer case | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
E | U | E | U | E | U | E | U | LAR | LBR | ||
Burton [ 35], et al. 2018 | Canada | 5859 | 1,292,059 | 30.4 ± 5.8 | 28.7 ± 5.7 | F:5859 | F:1292059 | 27 | 10,080 | – | – |
Nordenskjöld [ 10], et al. 2017 | Sweden | 15,534 | 51,398 | 41.27 | 38.88 | 7786 7748 | 26,296 25,102 | 23 | 45 | – | – |
Hung [ 36], et al. 2013 | China | 18,697 | 19,109 | 62.5 ± 13.9 | 60.2 ± 14.8 | 8330 10,367 | 10,799 8310 | 954 | 885 | – | – |
Olsen [ 54], et al. 2014 | Denmark | 15,104 | 15,104 | NA | NA | NA | NA | 37 | NA | – | – |
Shao [ 8], et al. 2020 | China | 56,050 | 560,491 | > 25 | > 25 | 31,857 24,193 | 309,561 241,921 | 2552 | 17,613 | – | – |
Davis [ 11], et al. 2011 | America | 205 | 333 | 48.5 ± 12.3 | 49.8 ± 12.5 | 91 114 | 178 155 | 56 | 72 | – | – |
Rampinelli [ 9], et al. 2017 | Italy | 5203 | NA | > 50 | NA | 1764 3439 | NA | – | – | 1,600,000 653 | 1,600,000 136.9 |
Kritsaneepaiboon [ 37], et al. 2016 | Thailand | 328 | NA | 40.10 ± 15.81 | NA | 73 255 | NA | – | – | 100,000 140 | 100,000 18.4 |
Griffey [ 38], et al. 2009 | America | 130 | NA | 56 | NA | 82 48 | NA | – | – | 100,000 1219.5 | 100,000 14.4 |
Einstein [ 39], et al. 2008 | America | 50 | NA | 61 ± 12 | NA | 20 30 | NA | – | – | 100,000 62.7 | 100,000 12.9 |
Faletra [ 40], et al. 2010 | Sweden | 749 | NA | 52–70 | NA | 280 469 | NA | – | – | 2,100,000 5306.9 | 2,100,000 253.1 |
Niemann [ 41],et al 2013 | Sweden | 691 | NA | 66 | NA | 339 352 | NA | – | – | 8,700,000 538.6 | 8,700,000 143.3 |
Huang [ 42], et al. 2009 | China and America | NA | NA | 20–80 | NA | NA | NA | – | – | 23,200,000 19,493 | 23,200,000 404.1 |
Perisinakis [ 43], et al. 2015 | Greece | 136 | NA | F:59.4 M:60.6 | NA | 41 95 | NA | – | – | 100,000 71.5 | 100,000 27 |
Smith-Bindman [ 2], et al. 2009 | America | 1119 | NA | 59 | NA | 535 584 | NA | – | – | 200,000 423 | 200,000 51.6 |
Sodickson [ 44], et al. 2009 | America | 31,462 | NA | 56.9 ± 17.5 | NA | 13,843
17,619 | NA | – | – | 100,000 300 | 100,000 28.9 |
Huang [ 45], et al. 2009 | China | NA | NA | 20–80 | NA | NA | NA | – | – | 12,500,000 8690 | 12,500,000 204.1 |
Huda [ 46], et al. 2010 | America | 100 | NA | 59 ± 11 | NA | 60 40 | NA | – | – | 200,000 231 | 200,000 29.5 |
Perisinakis [ 47], et al. 2012 | Greece | 62 | NA | F:61 ± 10 M:59 ± 13 | NA | 31 31 | NA | – | – | 200,000 59 | 200,000 25.8 |
Einstein [ 48], et al. 2007 | America | NA | NA | 61 ± 12 | NA | NA | NA | – | – | 800,000 1702.1 | 800,000 134.9 |
Kim [ 49], et al. 2009 | America | NA | NA | F:45–75 M:55–75 | NA | NA | NA | – | – | 1,300,000 102 | 1,300,000 112.7 |
Majer [ 50], et al. 2018 | Croatia | NA | NA | NA | NA | NA | – | – | 2,200,000 1410 | 2,200,000 55.3 | |
Salibi [ 51], et al. 2014 | America | 67 | NA | 34 ± 14 | NA | 54 13 | NA | – | – | 100,000 810 | 100,000 39.4 |
Shah [ 52], et al. 2013 | America | 24,393 | NA | 23–84 | NA | NA | NA | – | – | 200,000 1163.5 | 200,000 32.7 |
Wylie [53], et al. 2018 | America | 3863 | NA | 20–60 | NA | 3434 429 | NA | – | – | 1,000,000 880 | 1,000,000 199.7 |
Study | Study Type | Reason | CT scanner | NO. of CT scan (CT sites, participants) | Effective dose (mSv) | Cumulative dose (mSv) | Observation time | Follow-up (Y) | |
---|---|---|---|---|---|---|---|---|---|
E | U | ||||||||
Burton [ 35], et al. 2018 | A | NA | NA | 1, 5655 ≥ 2, 204 | 10–44 | NA | 1995–2004 | 5.9 | 11.1 |
Nordenskjöld [ 10], et al. 2017 | A | NA | NA | NA | NA | NA | 1973–1992 | 22.5 | 21.9 |
Hung [ 36], et al. 2013 | A | CAD | NA | 1–5, 657 ≥ 6, 297 | NA | NA | 1997–2010 | 12 | 12 |
Olsen [ 54], et al. 2014 | A | CHD | NA | NA | NA | NA | 1977–2008 | 8 | 8 |
Shao [ 8], et al. 2020 | B | NA | NA | 1–3, 17,423 ≥ 4, 2742 | 0.5–17.0 | 0.5–71.3 | 2000–2013 | 9.3- 9.9 | 9.3- 9.9 |
Davis [ 11], et al. 2011 | B | NA | NA | 1–2, 98 ≥ 3, 30 | 2 | 1.5–10 | 2003.04–2007.12 | 2 | 2 |
Rampinelli [ 9], et al. 2017 | C | LCS | NA | NA | M: 1.0 F: 1.4 | M: 9.3 F: 13 | 2004–2015 | 10 | 10 |
Kritsaneepaiboon [ 37], et al. 2016 | NA | Multiple-injury | 64-multislice and 16-multislice CT, Phillips Brilliance | NA | NA | 19.43 ± 21.31 | 2013.01.01- 2013.12.31 | 1 | NA |
Griffey [ 38], et al. 2009 | C | Emergency | 64-multislice CT | NA | NA | 122 | 2005.06.01–2006.05.31 | 7.7 | NA |
Einstein [ 39], et al. 2008 | C | NA | Siemens AG 16-slice | NA | 8.8 ± 2.9 | NA | NA | NA | NA |
Faletra [ 40], et al. 2010 | C | Coronary disease | 64-slice CTCA | NA | Low: M 3.9 ± 1.7, F 3.1 ± 1.4 High: M 23.3 ± 4.0, F 22.3 ± 2.3 | NA | NA | NA | NA |
Niemann [ 41],et al 2013 | C | PE | Siemens Sensation 64;Siemens Sensation 16;Siemens Sensation 10 | NA | 4.35 ± 0.31 | NA | NA | 1 | NA |
Huang [ 42], et al. 2009 | NA | NA | 64-detector CT system (Discovery PET/CT,GE Healthcare, Milwaukee, Wis) | NA | M: 13.65, 24.80, 32.18 F: 13.45, 24.79, 31.91 | 100 | NA | NA | NA |
Perisinakis [ 43], et al. 2015 | D | NA | 256-slice CT | NA | 8.9 ± 0.9 | NA | NA | NA | NA |
Smith-Bindman [ 2], et al. 2009 | E | Various | NA | NA | 2–31 | NA | 2018.01.01–2018.05.30 | NA | NA |
Sodickson [ 44], et al. 2009 | A | Cysticfibrosis | NA | NA | NA | 54.3 | 1985–2007 | NA | NA |
Huang [ 45], et al. 2009 | D | NA | NA | NA | 45–73 | 100 | NA | NA | NA |
Huda [ 46], et al. 2010 | C | CAD | 64-MDCT scanner (Siemens Healthcare) | NA | 25.1 ± 4.9 | NA | NA | NA | NA |
Perisinakis [ 47], et al. 2012 | NA | NA | 256-slice TRO-CTA | NA | M: 3.8 ± 0.7 F: 6.5 ± 1.0 | NA | NA | NA | NA |
Einstein [ 48], et al. 2007 | NA | NA | 64-slice scanner (SOMATOM Sensation 64, Siemens AG, Munich, Germany) | NA | NA | lungs: 42–91 breast: 50–80 | NA | NA | NA |
Kim [ 49], et al. 2009 | NA | CAC | NA | NA | 3.1 | NA | 2000–2005 | NA | NA |
Majer [ 50], et al. 2018 | NA | NA | NA | NA | NA | 16–94 | NA | NA | NA |
Salibi [ 51], et al. 2014 | E | TBI | NA | NA | 87 ± 45 | NA | NA | NA | |
Shah [ 52], et al. 2013 | C | Emergency | NA | 83.4 | NA | 2001.01–2007.12 | NA | NA | |
Wylie [53], et al. 2018 | C | Hip Pain | NA | 30 | NA | 2015.01–2016.12 | NA | NA |
ROBs of included studies
Cancer risk from CT scans
n | OR (95% CI) | I [2](%), Pheterogeneity | Psubgroup | |
---|---|---|---|---|
All studies | 25 | 5.98 (3.46 to 10.35) | 99.61, 0.00 | |
Sex | 0.71 | |||
Men | 18 | 4.89 (2.40 to 9.96) | 99.43, 0.00 | |
Women | 18 | 5.88 (2.96 to 11.68) | 99.52, 0.00 | |
Age | 0.93 | |||
< 45 years | 11 | 5.79 (2.08 to 16.14) | 99.64, 0.00 | |
45 to 65 years | 11 | 5.04 (2.02 to 12.57) | 99.47, 0.00 | |
> 65 years | 8 | 6.66 (2.07 to 21.38) | 98.00, 0.00 | |
Scanning year | 0.88 | |||
Before 2007 | 8 | 3.83 (1.05 to 13.91) | 98.86, 0.00 | |
After 2007 | 5 | 3.39 (1.60 to 7.72) | 99.54, 0.00 | |
Data type | 0.00,0.00 | |||
Actual | 6 | 1.17 (0.89 to 1.55) | 94.18, 0.00 | |
Actual (Except Burton et al. 2018) | 5 | 1.32 (1.11 to 1.56) | 80.79, 0.00 | |
Estimate | 19 | 10.00 (5.87 to 17.05) | 99.14, 0.00 | |
Country | 0.19 | |||
NonAmerica | 14 | 4.65 (2.15 to 10.05) | 99.73, 0.00 | |
America | 12 | 9.56 (4.48 to 20.40) | 99.03, 0.00 | |
Continent | 0.58 | |||
Asia | 5 | 7.81 (1.57 to 38.89) | 99.91, 0.00 | |
Europe | 8 | 4.37 (2.00 to 9.56) | 98.74, 0.00 | |
America | 14 | 7.72 (3.42 to 17.42) | 99.19, 0.00 | |
Cancer type | 0.01 | |||
Nonleukemia | 14 | 5.57 (2.36 to 13.16) | 99.67, 0.00 | |
Leukemia | 5 | 1.66 (1.29 to 2.15) | 19.62, 0.21 | |
CT scan sites | 0.00 | |||
< 3 | 15 | 3.38 (1.80 to 6.33) | 99.23, 0.00 | |
≥ 3 | 10 | 14.08 (6.60 to 30.05) | 99.53, 0.00 | |
Quality scores | 0.25 | |||
< 5 | 14 | 8.04 (4.38 to 14.75) | 99.23, 0.00 | |
≥ 5 | 11 | 4.12 (1.57 to 10.86) | 99.69, 0.00 |