Improved radiation risk models applied to different patient groups in Sweden

In radiological diagnostics and therapy, it is important that practitioners, referrers, (i.e. radiologists, radiation oncologists and others in health-care) are aware of how much radiation a patient may receive from the various procedures used and associated health risk. The profession has a duty to...

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Main Authors: M. Andersson, K. Eckerman, D. Pawel, A. Almen, S. Mattsson
Format: Article
Language:English
Published: Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev 2019-06-01
Series:Радиационная гигиена
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Online Access:https://www.radhyg.ru/jour/article/view/613
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author M. Andersson
K. Eckerman
D. Pawel
A. Almen
S. Mattsson
author_facet M. Andersson
K. Eckerman
D. Pawel
A. Almen
S. Mattsson
author_sort M. Andersson
collection DOAJ
description In radiological diagnostics and therapy, it is important that practitioners, referrers, (i.e. radiologists, radiation oncologists and others in health-care) are aware of how much radiation a patient may receive from the various procedures used and associated health risk. The profession has a duty to inform patients or their representatives of the advantages and disadvantages of specific investigations or treatment plans. The need to estimate and communicate risks in connection with medical use of ionizing radiation is highlighted e.g. in the Russian Federation State Law No 3, §17.2,1996 and in the EU directive (2013/59/EURATOM 2014). The most commonly used way to express harm in relation to low doses of ionizing radiation is use of the quantity effective dose (E). Effective dose, a radiation protection quantity, however is not intended to provide risk estimates for medical exposures. Its purpose is to optimize conditions for radiation workers (18-65 years) or the general public; all groups with age distributions that differ from patients. In this paper the lifetime attributable risk was used to estimate the excess risk of receiving and dying of radiogenic cancer. The lifetime attributable risk estimations are generated from three different variables, gender, attained age and age at exposure giving the possibility to create age and gender specific cancer risk estimations. Initially, the US Environmental Protection Agency lifetime attributable risk coefficients which are intended to predict the cancer risk from ionizing radiation to a normal US population were applied. In this work, the lifetime attributable risk predictions were modified to the normal Swedish population and to cohorts of Swedish patients undergoing radiological and nuclear medicine examinations or treatments with survival times that differfrom the normal population. For Swedish males, all organs were given the same absorbed dose, exposed at 20, 40 and 70 years, the lifetime attributable risk coefficients (Gy-1) were 0.11, 0.068, and 0.038, respectively, which is lower than the corresponding figures for US males, 0.13, 0.077, and 0.040. For Swedish females, all organs were given the same absorbed dose, exposed at 40 years of age with a diagnosis of breast, colon or liver cancer, the lifetime attributable risk coefficients are 0.064, 0.034, and 0.0038, respectively, which is much lower than if a 40 years female without known cancer is exposed, 0.073.
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spelling doaj-art-31601cf67d8b4aac8eada5a57fa0abe92025-08-20T04:00:39ZengSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. RamzaevРадиационная гигиена1998-426X2019-06-01122445410.21514/1998-426X-2019-12-2-44-54579Improved radiation risk models applied to different patient groups in SwedenM. Andersson0K. Eckerman1D. Pawel2A. Almen3S. Mattsson4Medical Radiation Physics, Department of Translational MedicineCenter for Radiation Protection Knowledge, Oak Ridge National LaboratoryU.S. Environmental Protection AgencyMedical Radiation Physics, Department of Translational MedicineMedical Radiation Physics, Department of Translational MedicineIn radiological diagnostics and therapy, it is important that practitioners, referrers, (i.e. radiologists, radiation oncologists and others in health-care) are aware of how much radiation a patient may receive from the various procedures used and associated health risk. The profession has a duty to inform patients or their representatives of the advantages and disadvantages of specific investigations or treatment plans. The need to estimate and communicate risks in connection with medical use of ionizing radiation is highlighted e.g. in the Russian Federation State Law No 3, §17.2,1996 and in the EU directive (2013/59/EURATOM 2014). The most commonly used way to express harm in relation to low doses of ionizing radiation is use of the quantity effective dose (E). Effective dose, a radiation protection quantity, however is not intended to provide risk estimates for medical exposures. Its purpose is to optimize conditions for radiation workers (18-65 years) or the general public; all groups with age distributions that differ from patients. In this paper the lifetime attributable risk was used to estimate the excess risk of receiving and dying of radiogenic cancer. The lifetime attributable risk estimations are generated from three different variables, gender, attained age and age at exposure giving the possibility to create age and gender specific cancer risk estimations. Initially, the US Environmental Protection Agency lifetime attributable risk coefficients which are intended to predict the cancer risk from ionizing radiation to a normal US population were applied. In this work, the lifetime attributable risk predictions were modified to the normal Swedish population and to cohorts of Swedish patients undergoing radiological and nuclear medicine examinations or treatments with survival times that differfrom the normal population. For Swedish males, all organs were given the same absorbed dose, exposed at 20, 40 and 70 years, the lifetime attributable risk coefficients (Gy-1) were 0.11, 0.068, and 0.038, respectively, which is lower than the corresponding figures for US males, 0.13, 0.077, and 0.040. For Swedish females, all organs were given the same absorbed dose, exposed at 40 years of age with a diagnosis of breast, colon or liver cancer, the lifetime attributable risk coefficients are 0.064, 0.034, and 0.0038, respectively, which is much lower than if a 40 years female without known cancer is exposed, 0.073.https://www.radhyg.ru/jour/article/view/613effective doselife time attributable riskradiation risk predictions
spellingShingle M. Andersson
K. Eckerman
D. Pawel
A. Almen
S. Mattsson
Improved radiation risk models applied to different patient groups in Sweden
Радиационная гигиена
effective dose
life time attributable risk
radiation risk predictions
title Improved radiation risk models applied to different patient groups in Sweden
title_full Improved radiation risk models applied to different patient groups in Sweden
title_fullStr Improved radiation risk models applied to different patient groups in Sweden
title_full_unstemmed Improved radiation risk models applied to different patient groups in Sweden
title_short Improved radiation risk models applied to different patient groups in Sweden
title_sort improved radiation risk models applied to different patient groups in sweden
topic effective dose
life time attributable risk
radiation risk predictions
url https://www.radhyg.ru/jour/article/view/613
work_keys_str_mv AT mandersson improvedradiationriskmodelsappliedtodifferentpatientgroupsinsweden
AT keckerman improvedradiationriskmodelsappliedtodifferentpatientgroupsinsweden
AT dpawel improvedradiationriskmodelsappliedtodifferentpatientgroupsinsweden
AT aalmen improvedradiationriskmodelsappliedtodifferentpatientgroupsinsweden
AT smattsson improvedradiationriskmodelsappliedtodifferentpatientgroupsinsweden