title: Association between leukaemia and X-ray in children: a nationwide study.
abstract: OBJECTIVE
  The frequency of employing radiography is increasing. Long-term risks of performing X-ray procedures on children and adolescents for medical diagnosis have raised significant concerns.
  
  
  METHODS
  In this study, we adopt the case-control methodology to evaluate the relationship between the incidence rate of acute leukaemia and exposure to radiation during diagnostic X-ray examinations for children. Based on 1998-2010 data obtained from the Taiwan Bureau of National Health Insurance database, we selected 58 children with leukaemia and randomly selected an additional 232 children as the control group.
  
  
  RESULTS
  The mean age of children with leukaemia is 8.92 ± 5.24 years. The risk of leukaemia in children who underwent X-ray examinations increased 2.14-fold (95% CI, 1.18-3.87). In this study, we identified that, when undergoing X-ray examinations, the risk of leukaemia in children increased for both sex and age groups. Specifically, the relationship between leukaemia and X-ray in boys (OR = 3.28, 95%CI, 1.33-8.07) and in ages of 6 to 11 years (OR = 2.58, 95%CI, 1.09-6.10) was significant. Overall, the risk of leukaemia in children who underwent X-ray examinations progressively increased from a ratio of 1.65 to 3.14. Moreover, an identical trend was observed for boys (1.85 to 6.42).
  
  
  CONCLUSIONS
  Exposure to X-ray increased the risk of leukaemia in children.
authors.affiliation: Department of Radiology, Cheng Ching Hospital at Chung Kang and Graduate Institute of Clinical Science, China Medical University, Taichung, Taiwan.
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Shih
authors.forename: Jay
authors.initials: J
authors.lastname: Wu
authors.forename: Chin-Shin
authors.initials: CS
authors.lastname: Muo
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D016017:Odds Ratio; D011859:Radiography / Q000009:adverse effects*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: National Health Insurance; X-ray; case control study; children; leukaemia