Radiation Exposure From Medical Imaging Linked to Hematologic Cancer Risk in Children
FRIDAY, Sept. 19, 2025 -- Exposure to radiation from medical imaging is associated with a small but significantly increased risk for hematologic cancer among children, according to a study published online Sept. 17 in the New England Journal of Medicine.
Rebecca Smith‑Bindman, M.D., from the University of California, San Francisco, and colleagues followed a retrospective cohort of 3,724,623 children born between 1996 and 2016 in six U.S. health care systems and Ontario, Canada, to examine the risk for radiation-induced hematologic cancer from medical imaging.
A total of 2,961 hematologic cancers were diagnosed during 35,715,325 person-years of follow-up. Among children exposed to at least 1 mGy, the researchers found that mean exposure was 14.0 ± 23.1 mGy overall and 24.5 ± 36.4 mGy among children with hematologic cancer. There was an increase in cancer risk with cumulative dose, with relative risks of 1.41, 1.82, and 3.59 for 1 to <5 mGy, 15 to <20 mGy, and 50 to <100 mGy, respectively, compared with no exposure. An increased risk for all hematologic cancers was seen in association with cumulative radiation dose to bone marrow, with an excess relative risk of 2.54 per 100 mGy. Among children exposed to at least 30 mGy, the excess cumulative incidence of hematologic cancer by 21 years of age was 25.6 per 10,000. In this cohort, 10.1 percent of hematologic cancers may have been attributable to radiation exposure from medical imaging.
"While medical imaging can be lifesaving, our findings underscore the critical need to carefully evaluate and minimize radiation exposure during pediatric imaging to safeguard children’s long-term health," Smith-Bindman said in a statement. "This involves ensuring that imaging is performed only when it provides essential information for the child’s care and, in cases such as [computed tomography] scans, using the lowest possible radiation doses."
One author disclosed ties to the pharmaceutical industry and one author cofounded a company that collects and reports radiation dose and image quality associated with imaging but played no role in any aspect of the paper.
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