title: Lifetime attributable risk of cancer from CT among patients surviving severe traumatic brain injury.
abstract: OBJECTIVE
  The purpose of this study was to determine the lifetime attributable risk of cancer from CT among patients surviving severe traumatic brain injury.
  
  
  METHODS
  A retrospective cross-sectional study was conducted with prospectively collected data on patients 16 years old and older admitted with a Glasgow coma scale score of 8 or less to a single level 1 trauma center from 2007 to 2010. The effective dose of each CT examination the patients underwent was predicted with literature-accepted effective dose values of standard helical CT protocols. The lifetime attributable risk of cancer and related mortality incurred as a result of CT were estimated with the cumulative effective dose incurred from the time of injury to a 1-year follow-up evaluation and with the approach established by the Biologic Effects of Ionizing Radiation VII report.
  
  
  RESULTS
  The average patient was a 34-year-old man. The median number of CT examinations received during the first 12 months after injury was 20, and the average cumulative effective dose was 87 ± 45 mSv. This resulted in increases in the lifetime incidence of all cancer types from 45.5% to 46.3% and in the lifetime incidence of cancer-related mortality from 22.1% to 22.5%.
  
  
  CONCLUSIONS
  Radiation exposure from the use of CT in the evaluation and management of severe traumatic brain injury causes negligible increases in lifetime attributable risk of cancer and cancer-related mortality. Treating physicians should not allow the concern for future risk of radiation-induced cancer to influence decisions regarding radiographic evaluation in the acute treatment of traumatic brain injury.
authors.affiliation: 1 Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Salibi
authors.forename: Vikas
authors.initials: V
authors.lastname: Agarwal
authors.forename: David M
authors.initials: DM
authors.lastname: Panczykowski
authors.forename: Ava M
authors.initials: AM
authors.lastname: Puccio
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sheetz
authors.forename: David O
authors.initials: DO
authors.lastname: Okonkwo
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000401:mortality; D011829:Radiation Dosage; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*