Childhood and adult cancer after intrauterine exposure to ionizing radiation

Abstract

Since the reports in 1956 and 1958 that in utero radiation was associated with an increased risk of leukemia and solid cancers during childhood, this issue has been debated. Many epidemiological studies have been performed. Evidence for a causal association derives almost entirely from case-control studies, whereas practically all cohort studies find no association, most notably the series of atomic bomb survivors exposed in utero. Although it is likely that in utero radiation presents a leukemogenic risk to the fetus, the magnitude of the risk remains uncertain. The causal nature of the risk of cancers other than leukemia is less convincing, and the similar relative risks (RR = 1.5) for virtually all forms of childhood cancer suggests an underlying bias. Few studies have addressed the potential risk of adult cancer after intrauterine exposure. Radiotherapy given to newborns, however, has been linked to cancers of the thyroid and breast later in life.