Do Children With Spinal Deformity Who Have Metal Implants and Frequent Exposure to X-Rays Increase Their Risk of Cancer?
Adolescent
Adult
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Humans
Infant
Male
Metals
/ adverse effects
Middle Aged
Neoplasms
/ diagnosis
Prostheses and Implants
/ adverse effects
Radiography
/ adverse effects
Registries
Risk Factors
South Australia
/ epidemiology
Spinal Diseases
/ diagnostic imaging
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Sep 2020
01 Sep 2020
Historique:
pubmed:
2
5
2020
medline:
17
12
2020
entrez:
2
5
2020
Statut:
ppublish
Résumé
Spinal surgery cohort. The authors assess the risk of cancer in children who have undergone frequent radiographs and have metal implants for the treatment of spinal deformity. Concerns have been raised regarding the cancer risk to children exposed to repeated radiological examinations as part of routine surveillance to monitor progression of spinal deformity. Additionally, there are reports of increased cancer risk in adults having joint replacement with metal implants causing raised metal ion levels in the blood. A large number of consecutive children undergoing instrumented spinal surgery since 1979 were examined for their development of malignancy. High quality data on all invasive cancers from the South Australian Cancer Registry and deaths were linked to the spinal surgery cohort with the calculation of standardized incidence ratios (SIRs) using the Quinquinquennium method. The study cohort was formed by 865 children. The average follow-up time from date of surgery to either death or censoring date was 18 years with a maximum of 36 years. A total of 15,921 person years were examined. There was no increased rate of cancer in these patients. For the total cohort, the SIR was 1.00 (95% confidence interval [CI] 0.50-1.79). For females the SIR was 0.83 (95% CI 0.33-1.70) and for males the SIR was 1.33 (95% CI 0.36-3.40). The male SIR reflected an expected cancer incidence of three cases, when four cases were observed, and was not statistically significant. This study has found that radiation exposure and possible exposure to circulating metal ions as a result of routine instrumented spine surgery in children since 1979 is not associated with an increased risk of cancer in up to 36 years of follow up. 2.
Sections du résumé
STUDY DESIGN
METHODS
Spinal surgery cohort.
OBJECTIVE
OBJECTIVE
The authors assess the risk of cancer in children who have undergone frequent radiographs and have metal implants for the treatment of spinal deformity.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Concerns have been raised regarding the cancer risk to children exposed to repeated radiological examinations as part of routine surveillance to monitor progression of spinal deformity. Additionally, there are reports of increased cancer risk in adults having joint replacement with metal implants causing raised metal ion levels in the blood.
METHODS
METHODS
A large number of consecutive children undergoing instrumented spinal surgery since 1979 were examined for their development of malignancy. High quality data on all invasive cancers from the South Australian Cancer Registry and deaths were linked to the spinal surgery cohort with the calculation of standardized incidence ratios (SIRs) using the Quinquinquennium method.
RESULTS
RESULTS
The study cohort was formed by 865 children. The average follow-up time from date of surgery to either death or censoring date was 18 years with a maximum of 36 years. A total of 15,921 person years were examined. There was no increased rate of cancer in these patients. For the total cohort, the SIR was 1.00 (95% confidence interval [CI] 0.50-1.79). For females the SIR was 0.83 (95% CI 0.33-1.70) and for males the SIR was 1.33 (95% CI 0.36-3.40). The male SIR reflected an expected cancer incidence of three cases, when four cases were observed, and was not statistically significant.
CONCLUSION
CONCLUSIONS
This study has found that radiation exposure and possible exposure to circulating metal ions as a result of routine instrumented spine surgery in children since 1979 is not associated with an increased risk of cancer in up to 36 years of follow up.
LEVEL OF EVIDENCE
METHODS
2.
Identifiants
pubmed: 32355145
doi: 10.1097/BRS.0000000000003507
pii: 00007632-202009010-00009
doi:
Substances chimiques
Metals
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1200-1207Commentaires et corrections
Type : CommentIn
Type : CommentIn
Références
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