title: Radiation-induced cancer: a modern view.
abstract: Diagnostic medical radiation has been the most rapidly increasing component of population background radiation exposure in Western countries over the past decade. This trend is set to increase as CT scanning is readily available with burgeoning use in everyday clinical practice. Consequently, the issue of cancer induction from the doses received during diagnostic medical exposures is highly relevant. In this review we explain current understanding of potential cancer induction at low doses of sparsely ionising radiation. For cancers that may be induced at low doses, a mechanistic description of radiation-induced cancer is discussed, which, in combination with extrapolation of data based on population cohort studies, provides the basis of the currently accepted linear no-threshold model. We explore the assumptions made in deriving risk estimates, the controversies surrounding the linear no-threshold model and the potential future challenges facing clinicians and policy-makers with regards to diagnostic medical radiation and cancer risk, most notably the uncertainties regarding deriving risk estimates from epidemiological data at low doses.
authors.affiliation: Department of Radiology, Northwick Park Hospital, Harrow, UK. dhirenshah@nhs.net
authors.forename: D J
authors.initials: DJ
authors.lastname: Shah
authors.forename: R K
authors.initials: RK
authors.lastname: Sachs
authors.forename: D J
authors.initials: DJ
authors.lastname: Wilson
mesh_terms: D000367:Age Factors; D000818:Animals; D017209:Apoptosis / Q000528:radiation effects; D014408:Biomarkers, Tumor / Q000378:metabolism; D002450:Cell Communication / Q000528:radiation effects; D016922:Cellular Senescence / Q000528:radiation effects; D004249:DNA Damage; D004260:DNA Repair / Q000528:radiation effects; D004195:Disease Models, Animal; D004198:Disease Susceptibility / Q000209:etiology; D004307:Dose-Response Relationship, Radiation; D042822:Genomic Instability / Q000528:radiation effects; D006657:Histones / Q000378:metabolism; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D007107:Immune System / Q000528:radiation effects; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000276:immunology; D011859:Radiography / Q000009:adverse effects*; D018570:Risk Assessment; D019139:Tumor Escape / Q000528:radiation effects
chemical_list: D014408:Biomarkers, Tumor; C468783:H2AX protein, human; D006657:Histones