X线致癌的可能性

2005年高居医患关心话题第5名（美国）

    这里是对医源性放射性影响进行地客观、公正的评价。

     JERRYDOCTOR 在译此文时发现，有时中文难以准确表达原文的意思，可能是我的英文不够好，也可能是我的中文不够好，或两者兼而有之。

    不过，我还知道，如果您读了很的英文原版教材后，也会发现大量诸如此类的问题。

    所以，我建议大家看我的译文时，如有疑问，就多读原文，这并不困难。而且，这样获得的知识可能更准确。

Why Patients Are the Last to Know

           Another critical aspect of risk is this question: What kind of cancers (malignancies) are triggered by imaging radiation, and when do they occur? As preface to this, the answer in part explains why this information is not generally being conveyed, to date, to patients prior to their undergoing a CT study. First, the cancers are relatively common in the general population, which means that it is difficult to sort out which cancers have occurred as a direct result from x-rays (unlike, for example, mesothelioma, which is an extremely rare cancer, and therefore its association with asbestos exposure was relatively easy to ascertain); second, the latency period between exposure to x-rays and development of cancer may be extremely long, up to 20 years, which means that the association may be difficult both to deduce and to prove. BEIR VII (and other sources) reported that the malignancies most associated with x-ray exposure are leukemia, thyroid, and breast cancers.[1] The latency period between exposure and development of malignancy they report as 2-5 years for leukemias (and other blood line tumors) and 10-20 years for solid tumors (sarcoma, breast cancers). Twenty years is a long time -- after 20 years generally the ordering physician or nurse is gone, the radiologist is gone, and the only one left is the patient, who received x-ray radiation as a child and now harbors a malignancy in middle age.       

为什么患者总是最后知道

      另一种重要的问题是：由医源性放射可触发哪些恶性肿瘤，何时发生？谈到这一点，此答案的部分解释为何没有在患者进行CT检查之前，目前为上还是这样，通常告诉给他们。 首先，癌症在一般人群中并不常见，这意味着找出那些直接因X线导致的肿瘤是困难的（例如，还不如间皮瘤－一种极罕见的癌，与暴露在石棉环境中发生的更容易发现）。其次，在暴露到X线后与发生肿瘤之间的延迟时间过于长，多的长达20年，这意味着两者之间的相关性很难以推论和证实。BEIR 7 （还有别的一些报道）发现常与X线暴露有关的是恶性肿瘤是白血病、甲状腺肿瘤、乳腺癌。暴露到X线后与发生恶性肿瘤之间的潜伏期对于白血病（还有别的一些血液疾病）是2～5年，一些实体肿瘤（肉瘤、乳腺癌）是10～20年。20年的时间是太长了－－－一般20年之后，原来的医师或护士早已不在，放射医师也去了，惟一还在是患者，儿时接受了放射性检查，现在已是中年。

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