%0 Journal Article
%T Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995.
%A Gu Y
%A Wang J
%A Wang Y
%A Xu C
%A Liu Y
%A Du L
%A Wang Q
%A Ji K
%A He N
%A Zhang M
%A Song H
%A Niu K
%A Liu Q
%J Occup Environ Med
%V 80
%N 12
%D 2023 Nov 23
%M 37918914
%F 4.948
%R 10.1136/oemed-2023-108875
%X <B>BACKGROUND: </B>The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers.<BR><B>METHODS: </B>This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose.<BR><B>RESULTS: </B>1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers.<BR><B>CONCLUSIONS: </B>These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.