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Gus Iversen, Editor in Chief | October 06, 2025
A study of nearly 4 million children and adolescents suggests that approximately 10% of pediatric blood and bone marrow cancers may be tied to radiation exposure from medical imaging procedures.
Published September 17 in
The New England Journal of Medicine, the study was led by researchers from UC San Francisco and UC Davis and is considered the most comprehensive North American analysis of its kind. Investigators analyzed imaging histories for children born between 1996 and 2016 across six U.S. health systems and one in Ontario, Canada.
The findings point to a dose-dependent relationship between radiation from imaging and the risk of hematologic malignancies, including leukemia and lymphoma. Among children who underwent head CT scans, researchers attributed roughly 25% of subsequent blood cancers to radiation exposure. The risk of cancer was 1.8 times higher for children who had one or two head CTs, increasing to 3.5 times for those with more exposure.
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“Children are particularly vulnerable to radiation-induced cancer due to their heightened radiosensitivity and longer life expectancy,” said Dr. Rebecca Smith-Bindman, a UCSF radiologist and the study’s lead author. “While medical imaging can be lifesaving, our findings underscore the critical need to carefully evaluate and minimize radiation exposure during pediatric imaging to safeguard children’s long-term health.”
The researchers recorded 2,961 hematologic malignancies during the study period. Lymphoid cancers made up over 79% of cases, with nearly half diagnosed in children under age 5.
CT was identified as the primary source of ionizing radiation, while conventional radiographs, though more common, were associated with significantly lower doses and a much smaller cancer risk. The study recommends considering nonionizing alternatives like MR or ultrasound when possible.
“This study provides robust, directly observed evidence of a clear dose-response relationship between radiation from medical imaging and hematologic malignancy risk,” said Dr. Diana Miglioretti, senior author and professor of biostatistics at UC Davis Health.
The research was funded by the National Cancer Institute and supported in part by the Ontario Ministry of Health and Long-Term Care.
