• DOI:10.1148/RADIOL.2312030880
• Corpus ID: 25574116

Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer.

@article{Brenner2004RadiationRP,
  title={Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer.},
  author={David J. Brenner},
  journal={Radiology},
  year={2004},
  volume={231 2},
  pages={
          440-5
        }
}

• D. Brenner
• Published 1 May 2004
• Medicine, Physics
• Radiology

PURPOSE
To estimate the radiation-related lung cancer risks associated with annual low-dose computed tomographic (CT) lung screening in adult smokers and former smokers, and to establish a baseline risk that the potential benefits of such screening should exceed.

MATERIALS AND METHODS
The estimated lung radiation dose from low-dose CT lung examinations corresponds to a dose range for which there is direct evidence of increased cancer risk in atomic bomb survivors. Estimated dose-, sex-, and smoking status-dependent excess relative risks of lung cancer were derived from cancer incidence data for atomic bomb survivors and used to calculate the excess lung cancer risks associated with a single CT lung examination at a given age in a U.S. population. From these, the overall radiation risks associated with annual CT lung screening were estimated.

RESULTS
A 50-year-old female smoker who undergoes annual CT lung screening until age 75 would incur an estimated radiation-related lung cancer risk of 0.85%, in addition to her otherwise expected lung cancer risk of approximately 17%. The radiation-associated cancer risk to other organs would be far lower. If 50% of all current and former smokers in the U.S. population aged 50-75 years received annual CT screening, the estimated number of lung cancers associated with radiation from screening would be approximately 36,000, a 1.8% (95% credibility interval: 0.5%, 5.5%) increase over the otherwise expected number.

CONCLUSION
Given the estimated upper limit of a 5.5% increase in lung cancer risk attributable to annual CT-related radiation exposure, a mortality benefit of considerably more than 5% may be necessary to outweigh the potential radiation risks.