NR 505 Week 3 Collaboration Cafe

Student Name

Chamberlain University

NR-505: Advanced Research Methods: Evidence-Based Practice

Prof. Name:

Date

Title: Assessing the Impact of CT Scan Radiation on Cancer Risk in Children and Young Adults: A Cohort Study Review

Purpose of the Study

The study I reviewed for this week’s assignment is titled “Are the Studies on Cancer Risk From CT Scans Biased by Indication? Elements of Answer from a Large-Scale Cohort Study in France” (Journy et al., 2015). This research aims to explore the potential link between computed tomography (CT) radiation exposure during childhood and the development of cancer, specifically investigating if reduced radiation doses can lower cancer risks. The PICOT question guiding this study is: In children and young adults, does the use of a reduced dose of radiation exposure from CT scans reduce the risk of cancer compared to higher doses over their lifetime? The study utilizes a quantitative design to assess whether increased CT exposure during early years influences the likelihood of cancer and how other risk factors may alter the radiation-related risks.

Research Design and Methodology

This study employs a quantitative research design, focusing on the collection and analysis of numerical data to identify correlations between CT exposure and cancer risk. Quantitative research methods are highly effective for determining relationships between variables in large populations. In this case, the study analyzes data from a large cohort of children and young adults who underwent CT scans during childhood. The goal was to determine whether increased CT exposure during childhood and adolescence contributes to cancer risk and how other predispositions might influence the results.

Sample and Population

The study’s target population was a nonprobability sample, meaning that participants were chosen based on certain criteria necessary for inclusion. Specifically, the study examined 67,274 children born after January 1, 1995, who had received their first CT scans before the age of 10, between the years 2000 and 2010. These children had no prior cancer diagnoses at the time of the initial scan. The nonprobability sampling method is advantageous due to its convenience, affordability, and speed, although it can lead to potential biases and may not always represent the broader population effectively (Elfin & Negida, 2017).

Data Collection

Data collection occurred at 21 French university hospitals, specifically in 23 pediatric radiology departments. Data on CT exposure was gathered from various sources, including the electronic radiation information system (RIS), hospital discharge databases, and the Picture Archiving and Communication System (PACS). Cumulative radiation doses were calculated based on radiology protocols, and cancer diagnoses were obtained from the national childhood cancer registry. The study followed the participants from their first CT scan until either December 2011, their death, their first cancer diagnosis, or their 15th birthday—whichever occurred first.

Study Findings

The primary objective of this study was to investigate whether CT radiation exposure during childhood and adolescence leads to an increased risk of cancer. During the study period, 27 cases of central nervous system tumors, 25 cases of leukemia, and 21 cases of lymphoma were reported among the cohort. Additionally, the study found that 32% of these children had predisposing factors that could increase their cancer risk. However, the study concluded that a four-year follow-up period was not sufficient to draw definitive conclusions about the long-term risks of radiation exposure from CT scans.

Strengths of the Study

While the study does not explicitly list strengths, some notable advantages are evident. One significant strength is the large sample size, which provides robust data for analyzing the correlation between CT radiation and cancer risk. Additionally, the use of comprehensive data collection methods from multiple sources ensures that the results are based on accurate and reliable data. These factors enhance the credibility of the study’s findings and offer a strong foundation for future research.

Limitations of the Study

One notable limitation of this study is the lack of information regarding the specific reasons why the CT scans were conducted in the first place. It is possible that some scans were performed to investigate or monitor preexisting conditions that might increase cancer risk. The authors acknowledge that addressing this limitation would require collecting data on cancer predisposing factors, which could help clarify the relationship between CT exposure and cancer risk (Journy et al., 2015).

Recommendations for Future Practice

The study highlights several key recommendations for future practice. These include carefully evaluating CT scan exposures in pediatric patients and considering the uncertainties in radiation dose estimation for risk assessments. The authors also recommend promoting the optimization of CT procedures and advocating for the use of non-irradiating techniques, such as magnetic resonance imaging (MRI), especially for children and young adults (Journy et al., 2015).

Conclusion

This large-scale cohort study provides valuable insights into the potential risks associated with CT radiation exposure in children and young adults. While the study identifies several cases of cancer, the results suggest that further long-term research is needed to conclusively establish the link between CT scans and cancer. In the meantime, healthcare providers should be cautious in their use of CT scans in pediatric populations and consider alternative imaging methods when appropriate.

References

Journy, N., Rehel, J.L., Pointe, D.L., Lee, C., Brisse, H., Chateil, J.F., Caer-Lorho, S., Laurier, D., & Bernier, M.O. (2015). Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. British Journal of Cancer, 112, 185-193. Retrieved from https://www.nature.com/articles/bjc2014526#citeas