| Title: |
Epidemiological studies of low-dose ionizing radiation and cancer: Summary bias assessment and meta-analysis |
| Authors: |
Hauptmann, M; Daniels, RD; Cardis, E; Cullings, HM; Kendall, G; Laurier, D; Linet, MS; Little, MP; Lubin, JH; Preston, DL; Richardson, DB; Stram, DO; Thierry-Chef, I; Schubauer-Berigan, MK; Gilbert, ES; Berrington de Gonzalez, A |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2020 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Background Ionizing radiation is an established carcinogen, but risks from low-dose exposures are controversial. Since the Biological Effects of Ionizing Radiation VII review of the epidemiological data in 2006, many subsequent publications have reported excess cancer risks from low-dose exposures. Our aim was to systematically review these studies to assess the magnitude of the risk and whether the positive findings could be explained by biases. Methods Eligible studies had mean cumulative doses of less than 100 mGy, individualized dose estimates, risk estimates, and confidence intervals (CI) for the dose-response and were published in 2006–2017. We summarized the evidence for bias (dose error, confounding, outcome ascertainment) and its likely direction for each study. We tested whether the median excess relative risk (ERR) per unit dose equals zero and assessed the impact of excluding positive studies with potential bias away from the null. We performed a meta-analysis to quantify the ERR and assess consistency across studies for all solid cancers and leukemia. Results Of the 26 eligible studies, 8 concerned environmental, 4 medical, and 14 occupational exposure. For solid cancers, 16 of 22 studies reported positive ERRs per unit dose, and we rejected the hypothesis that the median ERR equals zero (P = .03). After exclusion of 4 positive studies with potential positive bias, 12 of 18 studies reported positive ERRs per unit dose (P = .12). For leukemia, 17 of 20 studies were positive, and we rejected the hypothesis that the median ERR per unit dose equals zero (P = .001), also after exclusion of 5 positive studies with potential positive bias (P = .02). For adulthood exposure, the meta-ERR at 100 mGy was 0.029 (95% CI = 0.011 to 0.047) for solid cancers and 0.16 (95% CI = 0.07 to 0.25) for leukemia. For childhood exposure, the meta-ERR at 100 mGy for leukemia was 2.84 (95% CI = 0.37 to 5.32); there were only two eligible studies of all solid cancers. Conclusions Our systematic assessments in this monograph ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1093/jncimonographs/lgaa010 |
| DOI: |
10.1093/jncimonographs/lgaa010 |
| Availability: |
https://doi.org/10.1093/jncimonographs/lgaa010; https://ora.ox.ac.uk/objects/uuid:d2d1674c-9aa1-4f9a-9c93-015851b985e8 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.444C0694 |
| Database: |
BASE |