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Analysis of the relation between exposure in childhood to ionising radiation during tomodensitometric examinations and the incidence of cancer within the "Cohort Enfant Scanner" cohort study

Neige Journy has defended her thesis on 14th November 2014 at Paul Brousse Hospital ​in Villejuif.

Document type > *Mémoire/HDR/Thesis

Keywords >


Authors > JOURNY Neige

Publication Date > 14/11/2014


​Medical exposure is an important source of exposure to ionizing radiation (IR) and is mostly related to radiodiagnostic imaging at low dose levels. Computed tomography (CT) is associated with higher IR doses than conventional radiography and the frequency of examinations and the related collective dose are increasing. A close attention has to be brought to the pediatric imaging because of the children’s radiosensitivity, their long life expectancy which could allow developing cancers and a lack of specific technical parameters’ adjustment during imaging. Epidemiological data are still insufficient to analyze the relation between cancer risk and exposure to CT and, more generally, exposures to low dose levels.


A national and multicentric cohort, Enfant Scanner, is carried out by the laboratory of epidemiology of IRSN to follow patients who had undergone one or more CT examinations in childhood. In 2010, 90,000 children exposed since 2000 were included from 19 radiology public departments. The French cohort is integrated in the European project EPI-CT, coordinated by the International Agency for Research on the Cancer and supported by the European Union in 2011. This project is getting together several national cohorts in order to increase the statistical power of the analyses.


The main objective is to assess the risk of cancer and leukemia associated with the IR exposure from CT examinations during childhood. First, a risk assessment will be performed based on dose-response models from published studies to estimate the expected cancer risk in the cohort and according to frequent exposure scenarios. Then, the cancer incidence risk will be analyzed amongst the included children in the cohort who were exposed between 2000 and 2011. The dose-response relationship between the cumulated exposure and the cancer incidence risk will be quantified and the potential modifying factors will be studied. An important stage of the research will be devoted to the choice of the methods of modeling the dose-response relation, the analysis of the dose variability amongst the centers and the dose uncertainty between the theoretical and individual estimations, and to the method to take account the underlying pathologies and comorbidities.


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