National Research Council. Health Risks from exposure to low levels of Ionizing Radiation: BEIR VII phase 2. Washington, DC: The National Academies Press; 2006. https://www.nap.edu/catalog/11340/health-risks-from-exposure-to-low-levels-of-ionizing-radiation. Accessed 11 July 2022.

Google Scholar 

United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). UNSCEAR 2006 report. Annex Epidemiol Stud Radiat Cancer N Y U N. 2008;13–322.

International Commission on Radiological Protection (ICRP). The 2007 recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37:1–332.

Google Scholar 

Berrington de Gonzalez A, Daniels RD, Cardis E, Cullings HM, Gilbert E, Hauptmann M, et al. Epidemiological studies of low-dose ionizing radiation and cancer: rationale and framework for the monograph and overview of eligible studies. J Natl Cancer Inst Monogr. 2020;2020:97–113. https://doi.org/10.1093/jncimonographs/lgaa009.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hauptmann M, Daniels RD, Cardis E, Cullings HM, Kendall G, Laurier D, et al. Epidemiological studies of low-dose ionizing radiation and cancer: summary bias assessment and meta-analysis. J Natl Cancer Inst Monogr. 2020;2020:188–200. https://doi.org/10.1093/jncimonographs/lgaa010.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Cohen S, Gurvitz MZ, Beauséjour-Ladouceur V, Lawler PR, Therrien J, Marelli AJ. Cancer risk in congenital heart disease–what is the evidence? Can J Cardiol. 2019;35:1750–61. https://doi.org/10.1016/j.cjca.2019.09.023.

Article  PubMed  Google Scholar 

Abalo KD, Rage E, Leuraud K, Richardson DB, Le Pointe HD, Laurier D, et al. Early life ionizing radiation exposure and cancer risks: systematic review and meta-analysis. Pediatr Radiol. 2021;51:45–56. https://doi.org/10.1007/s00247-020-04803-0.

Article  PubMed  Google Scholar 

Little MP, Wakeford R, Bouffler SD, Abalo K, Hauptmann M, Hamada N, et al. Review of the risk of cancer following low and moderate doses of sparsely ionising radiation received in early life in groups with individually estimated doses. Environ Int. 2022;159:106983. https://doi.org/10.1016/j.envint.2021.106983.

Article  CAS  PubMed  Google Scholar 

de Berrington A, Pasqual E, Veiga L. Epidemiological studies of CT scans and cancer risk: the state of the science. Br J Radiol. 2021;94:20210471. https://doi.org/10.1259/bjr.20210471.

Article  Google Scholar 

Grant EJ, Brenner A, Sugiyama H, Sakata R, Sadakane A, Utada M, et al. Solid cancer incidence among the life span study of atomic bomb survivors: 1958–2009. Radiat Res. 2017;187:513–37. https://doi.org/10.1667/rr14492.1.

Article  CAS  PubMed  Google Scholar 

Mettler FA, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot. 2000;20:353–9. https://doi.org/10.1088/0952-4746/20/4/301.

Article  PubMed  Google Scholar 

Mettler FA, Bhargavan M, Faulkner K, Gilley DB, Gray JE, Ibbott GS, et al. Radiologic and Nuclear Medicine Studies in the United States and Worldwide: frequency, Radiation Dose, and comparison with other Radiation sources – 1950–2007. Radiol Radiological Soc North Am. 2009;253:520–31. https://doi.org/10.1148/radiol.2532082010.

Article  Google Scholar 

National Council on Radiation Protection and Measurements (NCRP). Report No. 160 – Ionizing Radiation Exposure of the Population of the United States. Bethesda, MD 20814 – 3095, USA: National Council on Radiation Protection and Measurements (NCRP). ; 2009. https://ncrponline.org/shop/reports/report-no-160-ionizing-radiation-exposure-of-the-population-of-the-united-states/. Accessed 11 July 2022.

National Council on Radiation Protection and Measurements (NCRP). Report No. 184. Medical radiation exposure of patients in the United States. 7910 Woodmont Avenue, suite 400 / Bethesda, MD 20814 – 3095. USA: National Council on Radiation Protection and Measurements (NCRP); 2019.

Google Scholar 

Andreassi MG, Picano E. Reduction of Radiation to Children. Circulation. 2014;130:135–7. https://doi.org/10.1161/circulationaha.114.010699.

Article  PubMed  Google Scholar 

Modan B, Keinan L, Blumstein T, Sadetzki S. Cancer following cardiac catheterization in childhood. Int J Epidemiol. 2000;29:424–8.

Article  CAS  PubMed  Google Scholar 

McLaughlin JR, Kreiger N, Sloan MP, Benson LN, Hilditch S, Clarke EA. An historical cohort study of cardiac catheterization during childhood and the risk of cancer. Int J Epidemiol. 1993;22:584–91. https://doi.org/10.1093/ije/22.4.584.

Article  CAS  PubMed  Google Scholar 

Stern H, Seidenbusch M, Hapfelmeier A, Meierhofer C, Naumann S, Schmid I, et al. Increased cancer incidence following up to 15 years after cardiac catheterization in infants under one year between 1980 and 1998—a single center observational study. J Clin Med. 2020;9:315. https://doi.org/10.3390/jcm9020315.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Harbron RW, Chapple C-L, O’Sullivan JJ, Lee C, McHugh K, Higueras M, et al. Cancer incidence among children and young adults who have undergone x-ray guided cardiac catheterization procedures. Eur J Epidemiol. 2018;33:393–401. https://doi.org/10.1007/s10654-018-0357-0.

Article  PubMed  PubMed Central  Google Scholar 

Eisenberg MJ, Afilalo J, Lawler PR, Abrahamowicz M, Richard H, Pilote L. Cancer risk related to low-dose ionizing radiation from cardiac imaging in patients after acute myocardial infarction. CMAJ. 2011;183:430–6. https://doi.org/10.1503/cmaj.100463.

Article  PubMed  PubMed Central  Google Scholar 

Cohen S, Liu A, Gurvitz M, Guo L, Therrien J, Laprise C, et al. Exposure to low-dose ionizing radiation from cardiac procedures and malignancy risk in adults with congenital heart disease. Circulation. 2018;137:1334–45. https://doi.org/10.1161/circulationaha.117.029138.

Article  PubMed  Google Scholar 

Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. The Lancet. 2012;380:499–505. https://doi.org/10.1016/s0140-6736(12)60815-0.

Article  Google Scholar 

Journy N, Rehel J-L, Le Pointe D, Lee H, Brisse C, Chateil H. Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. Br J Cancer. 2015;112:185–93. https://doi.org/10.1038/bjc.2014.526.

Article  CAS  PubMed  Google Scholar 

Huang WY, Muo CH, Lin CY, Jen YM, Yang MH, Lin JC, et al. Paediatric head CT scan and subsequent risk of malignancy and benign brain tumour: a nation-wide population-based cohort study. Br J Cancer. 2014;110:2354–60. https://doi.org/10.1038/bjc.2014.103.

Article  PubMed  PubMed Central  Google Scholar 

Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, et al. Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ. 2013;346:f2360. https://doi.org/10.1136/bmj.f2360.

Article  PubMed  PubMed Central  Google Scholar 

Walsh L, Shore R, Auvinen A, Jung T, Wakeford R. Risks from CT scans—what do recent studies tell us? J Radiol Prot. 2014;34:E1–5. https://doi.org/10.1088/0952-4746/34/1/e1.

Article  PubMed  Google Scholar 

Little MP, Patel A, Lee C, Hauptmann M, Berrington de Gonzalez A, Albert P. Impact of reverse causation on estimates of Cancer Risk Associated with Radiation exposure from computerized tomography: a Simulation Study Modeled on Brain Cancer. Am J Epidemiol. 2022;191:173–81. https://doi.org/10.1093/aje/kwab247.

Article  PubMed  Google Scholar 

Baysson H, Nkoumazok B, Barnaoui S, Réhel J, Girodon B, Milani G, et al. Follow-up of children exposed to ionising radiation from cardiac catheterisation: the Coccinelle study. Radiat Prot Dosimetry. 2015;165:13–6. https://doi.org/10.1093/rpd/ncv039.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Cohen S, et al. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile. BMJ Open. 2021;11:e048576. https://doi.org/10.1136/bmjopen-2020-048576.

Article  PubMed  PubMed Central  Google Scholar 

Meulepas JM, Ronckers CM, Merks J, Weijerman ME, Lubin JH, Hauptmann M. Confounding of the association between radiation exposure from CT scans and risk of leukemia and brain tumors by cancer susceptibility syndromes. J Radiol Prot. 2016;36:953–74. https://doi.org/10.1088/0952-4746/36/4/953.

Article  PubMed  Google Scholar 

Berrington de Gonzalez A, Salotti JA, McHugh K, Little MP, Harbron RW, Lee C, et al. Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions. Br J Cancer. 2016;114:388–94. https://doi.org/10.1038/bjc.2015.415.

Article  PubMed  Google Scholar 

Tapiovaara M, Siiskonen T. A Monte Carlo program for calculating patient doses in medical X-ray examinations, STUK-A231 report. 2nd ed. Finland: STUK; 2008.

Google Scholar 

Johnson JN, Hornik CP, Li JS, Benjamin DK Jr, Yoshizumi TT, Reiman RE, et al. Cumulative radiation exposure and cancer risk estimation in children with heart disease. Circulation. 2014;130:161–7. https://doi.org/10.1161/circulationaha.113.005425.

Article  PubMed  PubMed Central  Google Scholar 

Glatz AC, Purrington KS, Klinger A, King AR, Hellinger J, Zhu X, et al. Cumulative exposure to medical radiation for children requiring surgery for congenital heart disease. J Pediatr. 2014;164:789–94. https://doi.org/10.1016/j.jpeds.2013.10.074.

Article  PubMed  Google Scholar 

Ait-Ali L, Andreassi MG, Foffa I, Spadoni I, Vano E, Picano E. Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease. Heart. 2010;96:269–74. https://doi.org/10.1136/hrt.2008.160309.

Article  PubMed  Google Scholar 

Journy N, Roué T, Cardis E, Le Pointe HD, Brisse H, Chateil J, et al. Childhood CT scans and cancer risk: impact of predisposing factors for cancer on the risk estimates. J Radiol Prot. 2016;36:N1–7. https://doi.org/10.1088/0952-4746/36/1/n1.

Article  CAS  PubMed  Google Scholar 

Journy NM, Dreuil S, Boddaert N, Chateil J-F, Defez D, Ducou-le-Pointe H, et al. Individual radiation exposure from computed tomography: a survey of paediatric practice in french university hospitals, 2010–2013. Eur Radiol Springer. 2018;28:630–41. https://doi.org/10.1007/s00330-017-5001-y.

Article  Google Scholar 

Lee C, Kim KP, Bolch WE, Moroz BE, Folio L. NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans. J Radiol Prot. 2015;35:891–909. https://doi.org/10.1088/0952-4746/35/4/891.

Article  CAS  PubMed  Google Scholar 

International Commission on Radiological Protection (ICRP). Stem cell biology with respect to carcinogenesis aspects of