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- Title
Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma.
- Authors
Boice Jr., John D.; Morin, Michele M.; Glass, Andrew G.; Friedman, Gary D.; Stovall, Marilyn; Hoover, Robert N.; Fraumeni Jr., Joseph F.; Evens, Ronald G.; Boice, J D Jr; Morin, M M; Glass, A G; Friedman, G D; Stovall, M; Hoover, R N; Fraumeni, J F Jr
- Abstract
Exposure to diagnostic x-rays and the risk of leukemia, non-Hodgkin's lymphoma (NHL), and multiple myeloma were studied within two prepaid health plans. Adult patients with leukemia (n = 565), NHL (n = 318), and multiple myeloma (n = 208) were matched to controls (n = 1390), and over 25,000 x-ray procedures were abstracted from medical records. Dose response was evaluated by assigning each x-ray procedure a score based on estimated bone marrow dose. X-ray exposure was not associated with chronic lymphocytic leukemia, one of the few malignant conditions never linked to radiation (relative risk [RR], 0.66). For all other forms of leukemia combined (n = 358), there was a slight elevation in risk (RR, 1.17) but no evidence of a dose-response relationship when x-ray procedures near the time of diagnosis were excluded. Similarly, patients with NHL were exposed to diagnostic x-ray procedures more often than controls (RR, 1.32), but the RR fell to 0.99 when the exposure to diagnostic x-ray procedures within 2 years of diagnosis was ignored. For multiple myeloma, overall risk was not significantly high (RR, 1.14), but there was consistent evidence of increasing risk with increasing numbers of diagnostic x-ray procedures. These data suggest that persons with leukemia and NHL undergo x-ray procedures frequently just prior to diagnosis for conditions related to the development or natural history of their disease. There was little evidence that diagnostic x-ray procedures were causally associated with leukemia or NHL. The risk for multiple myeloma, however, was increased among those patients who were frequently exposed to x-rays.
- Subjects
CALIFORNIA; OREGON; MEDICAL radiology; X-rays; LEUKEMIA risk factors; LYMPHOMA risk factors; MULTIPLE myeloma; MEDICAL care; DISEASE risk factors; CHRONIC lymphocytic leukemia; COMPARATIVE studies; RADIATION-induced leukemia; LYMPHOMAS; RESEARCH methodology; MEDICAL cooperation; RADIATION doses; RADIATION carcinogenesis; RADIOGRAPHY; REGRESSION analysis; RESEARCH; EVALUATION research; CASE-control method
- Publication
JAMA: Journal of the American Medical Association, 1991, Vol 265, Issue 10, p1290
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.1991.03460100092031