Skip to main content
Erschienen in: European Spine Journal 12/2020

27.08.2020 | Review Article

Cancer and mortality risks of patients with scoliosis from radiation exposure: a systematic review and meta-analysis

verfasst von: Fu-Jun Luan, Yi Wan, Kin-Cheung Mak, Chi-Jiao Ma, Hai-Qiang Wang

Erschienen in: European Spine Journal | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The study aimed for unraveling the long-term health impact of cumulative radiation exposure from full-spine radiographs on children/adolescents with scoliosis.

Methods

All cohort, case–control or cross-sectional studies about radiation exposure to scoliosis patients with follow-up period as 20 years or more were included. Meta-analyses were performed for outcomes reported in two or more studies.

Results

A total of 9 eligible studies involving 35,641 participants between 1912 and 1990 fulfilled the inclusion criteria, including 18,873 patients with scoliosis and 16,768 controls as regional matched general population. The average number of full-spine radiographs was 23.13 (range: 0–618) according to 14,512 patients between 1912 and 1990 in five studies. The estimated mean cumulated radiation dose of breast was 11.35 cGy. In comparison with controls, pooled incidence rates of cancer, breast cancer and cancer mortality of patients with scoliosis were statistically significant higher [rate of cancer, odds risk (OR) = 1.46, p < 0.00001; breast cancer, OR = 1.20, p = 0.02; cancer mortality, OR = 1.50, p < 0.00001]. No statistically significant differences were found in terms of reproductive events for scoliosis patients, pulmonary function and physical activity for adolescent idiopathic scoliosis patients.

Conclusions

Based on 35,641 participants with over 20 years’ observations from 1912 to 1990, repeated radiographs and pertaining cumulative radiation dose resulted in elevated rates of cancer, breast cancer and cancer mortality for children/adolescents with scoliosis in comparison with matched general population. It is recommended that low-radiation or radiation-free and efficient methods should be used to monitor the evolution of children/adolescents with scoliosis.
Literatur
1.
Zurück zum Zitat Reamy BV, Slakey JB (2001) Adolescent idiopathic scoliosis: review and current concepts. Am Fam Phys 64:111–116 Reamy BV, Slakey JB (2001) Adolescent idiopathic scoliosis: review and current concepts. Am Fam Phys 64:111–116
5.
Zurück zum Zitat Seung Yeol L, Eungi M, Jaekeon B, Chin Youb C, Kyoung Min L, Soon-Sun K, Moon Seok P, Kisung L (2013) Types and arrangement of thyroid shields to reduce exposure of surgeons to ionizing radiation during intraoperative use of C-arm fluoroscopy. Spine 38:2108–2112CrossRef Seung Yeol L, Eungi M, Jaekeon B, Chin Youb C, Kyoung Min L, Soon-Sun K, Moon Seok P, Kisung L (2013) Types and arrangement of thyroid shields to reduce exposure of surgeons to ionizing radiation during intraoperative use of C-arm fluoroscopy. Spine 38:2108–2112CrossRef
6.
Zurück zum Zitat Lee K, Lee KM, Park MS, Lee B, Kwon DG, Chung CY (1976) Measurements of surgeons’ exposure to ionizing radiation dose during intraoperative use of C-arm fluoroscopy. Spine 37:1240–1244CrossRef Lee K, Lee KM, Park MS, Lee B, Kwon DG, Chung CY (1976) Measurements of surgeons’ exposure to ionizing radiation dose during intraoperative use of C-arm fluoroscopy. Spine 37:1240–1244CrossRef
7.
Zurück zum Zitat Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, Huh Y, Lee K (2012) Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. Radiat Prot Dosimetry 148:431–438CrossRef Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, Huh Y, Lee K (2012) Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. Radiat Prot Dosimetry 148:431–438CrossRef
8.
Zurück zum Zitat Giordano BD, Ryder S, Baumhauer JF, DiGiovanni BF (2007) Exposure to direct and scatter radiation with use of mini-C-arm fluoroscopy. J Bone Joint Surg Am 89:948–952CrossRef Giordano BD, Ryder S, Baumhauer JF, DiGiovanni BF (2007) Exposure to direct and scatter radiation with use of mini-C-arm fluoroscopy. J Bone Joint Surg Am 89:948–952CrossRef
11.
Zurück zum Zitat Bohl DD, Hijji FY, Massel DH, Mayo BC, Long WW, Modi KD, Narain AS, Manning BT, Ahn J, Louie PK (2017) Patient knowledge regarding radiation exposure from spinal imaging. Spine J 17:305–312CrossRef Bohl DD, Hijji FY, Massel DH, Mayo BC, Long WW, Modi KD, Narain AS, Manning BT, Ahn J, Louie PK (2017) Patient knowledge regarding radiation exposure from spinal imaging. Spine J 17:305–312CrossRef
12.
Zurück zum Zitat Cohen J (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70:213–220CrossRef Cohen J (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70:213–220CrossRef
13.
Zurück zum Zitat Deeks JJ, Dinnes J, D’Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG (2003) Evaluating non-randomised intervention studies. Health Technol Assess (Winch Engl) 7:1–173CrossRef Deeks JJ, Dinnes J, D’Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG (2003) Evaluating non-randomised intervention studies. Health Technol Assess (Winch Engl) 7:1–173CrossRef
14.
Zurück zum Zitat Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101CrossRef Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101CrossRef
17.
Zurück zum Zitat Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRef Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRef
19.
Zurück zum Zitat Hai-Qiang Wang YW, Jun Zhang, Fu-Jun Luan, Xin He, Xin Tang, Ping-Heng Lan (2018) Long term impact of radiation exposure on children/adolescents with scoliosis: a systematic review and meta analysis. PROSPERO 2018 CRD42018092830 Hai-Qiang Wang YW, Jun Zhang, Fu-Jun Luan, Xin He, Xin Tang, Ping-Heng Lan (2018) Long term impact of radiation exposure on children/adolescents with scoliosis: a systematic review and meta analysis. PROSPERO 2018 CRD42018092830
21.
Zurück zum Zitat Doody MM, Lonstein JE, Stovall M, Hacker DG, Luckyanov N, Land CE (2000) Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study. Spine 25:2052–2063CrossRef Doody MM, Lonstein JE, Stovall M, Hacker DG, Luckyanov N, Land CE (2000) Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study. Spine 25:2052–2063CrossRef
22.
Zurück zum Zitat Goldberg MS, Mayo NE, Levy AR, Scott SC, PoTras B (1998) Adverse reproductive outcomes among women exposed to low levels of ionizing radiation from diagnostic radiography for adolescent idiopathic scoliosis. Epidemiology 9:271–278CrossRef Goldberg MS, Mayo NE, Levy AR, Scott SC, PoTras B (1998) Adverse reproductive outcomes among women exposed to low levels of ionizing radiation from diagnostic radiography for adolescent idiopathic scoliosis. Epidemiology 9:271–278CrossRef
23.
Zurück zum Zitat Hoffman DA, Lonstein JE, Morin MM, Visscher W, Harris BS 3rd, Boice JD Jr (1989) Breast cancer in women with scoliosis exposed to multiple diagnostic X-rays. J Natl Cancer Inst 81:1307–1312CrossRef Hoffman DA, Lonstein JE, Morin MM, Visscher W, Harris BS 3rd, Boice JD Jr (1989) Breast cancer in women with scoliosis exposed to multiple diagnostic X-rays. J Natl Cancer Inst 81:1307–1312CrossRef
25.
Zurück zum Zitat Levy AR, Goldberg MS, Hanley JA, Mayo NE, Poitras B (1994) Projecting the lifetime risk of cancer from exposure to diagnostic ionizing radiation for adolescent idiopathic scoliosis. Health Phys 66:621–633CrossRef Levy AR, Goldberg MS, Hanley JA, Mayo NE, Poitras B (1994) Projecting the lifetime risk of cancer from exposure to diagnostic ionizing radiation for adolescent idiopathic scoliosis. Health Phys 66:621–633CrossRef
26.
Zurück zum Zitat Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289:559–567CrossRef Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289:559–567CrossRef
27.
Zurück zum Zitat Visscher W, Lonstein JE, Hoffman DA, Mandel JS, Harris BS 3rd (1988) Reproductive outcomes in scoliosis patients. Spine 13:1096–1098CrossRef Visscher W, Lonstein JE, Hoffman DA, Mandel JS, Harris BS 3rd (1988) Reproductive outcomes in scoliosis patients. Spine 13:1096–1098CrossRef
29.
Zurück zum Zitat Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de Gonzalez A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet (Lond Engl) 380:499–505. https://doi.org/10.1016/S0140-6736(12)60815-0CrossRef Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de Gonzalez A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet (Lond Engl) 380:499–505. https://​doi.​org/​10.​1016/​S0140-6736(12)60815-0CrossRef
30.
Zurück zum Zitat Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, Giles GG, Wallace AB, Anderson PR, Guiver TA, McGale P, Cain TM, Dowty JG, Bickerstaffe AC, Darby SC (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ (Clin Res Ed) 346:f2360. https://doi.org/10.1136/bmj.f2360CrossRef Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, Giles GG, Wallace AB, Anderson PR, Guiver TA, McGale P, Cain TM, Dowty JG, Bickerstaffe AC, Darby SC (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ (Clin Res Ed) 346:f2360. https://​doi.​org/​10.​1136/​bmj.​f2360CrossRef
37.
Zurück zum Zitat Gray JE, Hoffman AD, Peterson HA (1983) Reduction of radiation exposure during radiography for scoliosis. J Bone Joint Surg Am 65:5–12CrossRef Gray JE, Hoffman AD, Peterson HA (1983) Reduction of radiation exposure during radiography for scoliosis. J Bone Joint Surg Am 65:5–12CrossRef
44.
Zurück zum Zitat Force USPST, Grossman DC, Curry SJ, Owens DK, Barry MJ, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW (2018) Screening for adolescent idiopathic scoliosis: US preventive services task force recommendation statement. JAMA 319:165–172. https://doi.org/10.1001/jama.2017.19342CrossRef Force USPST, Grossman DC, Curry SJ, Owens DK, Barry MJ, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW (2018) Screening for adolescent idiopathic scoliosis: US preventive services task force recommendation statement. JAMA 319:165–172. https://​doi.​org/​10.​1001/​jama.​2017.​19342CrossRef
45.
Zurück zum Zitat Marshall NW, Faulkner K, Busch HP, Marsh DM, Pfenning H (1994) A comparison of radiation dose in examination of the abdomen using different radiological imaging techniques. Br J Radiol 67:478–484CrossRef Marshall NW, Faulkner K, Busch HP, Marsh DM, Pfenning H (1994) A comparison of radiation dose in examination of the abdomen using different radiological imaging techniques. Br J Radiol 67:478–484CrossRef
46.
Zurück zum Zitat Ghearr FANA, Brennan PC (1998) The PA projection of the abdomen: a dose reducing technique. Radiography 4:195–203CrossRef Ghearr FANA, Brennan PC (1998) The PA projection of the abdomen: a dose reducing technique. Radiography 4:195–203CrossRef
47.
Zurück zum Zitat Brennan PC, Madigan E (2000) Lumbar spine radiology: analysis of the posteroanterior projection. Eur Radiol 10:1197–1201CrossRef Brennan PC, Madigan E (2000) Lumbar spine radiology: analysis of the posteroanterior projection. Eur Radiol 10:1197–1201CrossRef
48.
Zurück zum Zitat Sharr JRP, Mohammed KD (2003) Optimizing the radiographic technique in clavicular fractures. J Shoulder Elbow Surg 12:170–172CrossRef Sharr JRP, Mohammed KD (2003) Optimizing the radiographic technique in clavicular fractures. J Shoulder Elbow Surg 12:170–172CrossRef
49.
Zurück zum Zitat Mc Entee MF, Catherine K (2010) The PA projection of the clavicle: a dose-reducing technique. Radiat Prot Dosimetry 139:539CrossRef Mc Entee MF, Catherine K (2010) The PA projection of the clavicle: a dose-reducing technique. Radiat Prot Dosimetry 139:539CrossRef
52.
Zurück zum Zitat Dietrich TJ, Pfirrmann CWA, Schwab A, Pankalla K, Buck FM (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol 42:959–967. https://doi.org/10.1007/s00256-013-1600-0CrossRefPubMed Dietrich TJ, Pfirrmann CWA, Schwab A, Pankalla K, Buck FM (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol 42:959–967. https://​doi.​org/​10.​1007/​s00256-013-1600-0CrossRefPubMed
Metadaten
Titel
Cancer and mortality risks of patients with scoliosis from radiation exposure: a systematic review and meta-analysis
verfasst von
Fu-Jun Luan
Yi Wan
Kin-Cheung Mak
Chi-Jiao Ma
Hai-Qiang Wang
Publikationsdatum
27.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 12/2020
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-020-06573-7

Weitere Artikel der Ausgabe 12/2020

European Spine Journal 12/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.