Abstract:
OBJECTIVE:To estimate the risk of breast cancer associated with diagnostic radiation in carriers of BRCA1/2 mutations. DESIGN:Retrospective cohort study (GENE-RAD-RISK). SETTING:Three nationwide studies (GENEPSO, EMBRACE, HEBON) in France, United Kingdom, and the Netherlands, PARTICIPANTS:1993 female carriers of BRCA1/2 mutations recruited in 2006-09. MAIN OUTCOME MEASURE:Risk of breast cancer estimated with a weighted Cox proportional hazards model with a time dependent individually estimated cumulative breast dose, based on nominal estimates of organ dose and frequency of self reported diagnostic procedures. To correct for potential survival bias, the analysis excluded carriers who were diagnosed more than five years before completion of the study questionnaire. RESULTS:In carriers of BRCA1/2 mutations any exposure to diagnostic radiation before the age of 30 was associated with an increased risk of breast cancer (hazard ratio 1.90, 95% confidence interval 1.20 to 3.00), with a dose-response pattern. The risks by quarter of estimated cumulative dose <0.0020 Gy, ≥ 0.0020-0.0065 Gy, ≥ 0.0066-0.0173 Gy, and ≥ 0.0174 Gy were 1.63 (0.96 to 2.77), 1.78 (0.88 to 3.58), 1.75 (0.72 to 4.25), and 3.84 (1.67 to 8.79), respectively. Analyses on the different types of diagnostic procedures showed a pattern of increasing risk with increasing number of radiographs before age 20 and before age 30 compared with no exposure. A history of mammography before age 30 was also associated with an increased risk of breast cancer (hazard ratio 1.43, 0.85 to 2.40). Sensitivity analysis showed that this finding was not caused by confounding by indication of family history. CONCLUSION:In this large European study among carriers of BRCA1/2 mutations, exposure to diagnostic radiation before age 30 was associated with an increased risk of breast cancer at dose levels considerably lower than those at which increases have been found in other cohorts exposed to radiation. The results of this study support the use of non-ionising radiation imaging techniques (such as magnetic resonance imaging) as the main tool for surveillance in young women with BRCA1/2 mutations.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Pijpe A,Andrieu N,Easton DF,Kesminiene A,Cardis E,Noguès C,Gauthier-Villars M,Lasset C,Fricker JP,Peock S,Frost D,Evans DG,Eeles RA,Paterson J,Manders P,van Asperen CJ,Ausems MG,Meijers-Heijboer H,Thierry-Chef I,Haudoi
10.1136/bmj.e5660subject
Has Abstractpub_date
2012-09-06 00:00:00pages
e5660eissn
0959-8138issn
1756-1833journal_volume
345pub_type
杂志文章abstract:OBJECTIVE:To study the role of respiratory viruses in exacerbations of asthma in adults. DESIGN:Longitudinal study of 138 adults with asthma. SETTING:Leicestershire Health Authority. SUBJECTS:48 men and 90 women 19-46 years of age with a mean duration of wheeze of 19.6 years. 75% received regular treatment with bron...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6910.982
更新日期:1993-10-16 00:00:00
abstract:UNLABELLED:OBJECTIVE--To measure needs for care of patients aged 18-65 years with major mental illness. DESIGN:Identification of everyone in one area seen by a health professional within the previous five years because of a psychotic disorder. Interview of a one in three sample of patients and their main carers with t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7046.1582
更新日期:1996-06-22 00:00:00
abstract:OBJECTIVE:To compare health behaviours during pregnancy (smoking and alcohol consumption) and after birth (initiation and duration of breast feeding) between British/Irish white mothers and mothers from ethnic minority groups; and, in mothers from ethnic minority groups, to examine whether indicators of acculturation (...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39532.688877.25
更新日期:2008-05-10 00:00:00
abstract:OBJECTIVE:To determine the most effective tocolytic agent at delaying delivery. DESIGN:Systematic review and network meta-analysis. DATA SOURCES:Cochrane Central Register of Controlled Trials, Medline, Medline In-Process, Embase, and CINAHL up to 17 February 2012. STUDY SELECTION:Randomised controlled trials of toco...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
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更新日期:2012-10-09 00:00:00
abstract:OBJECTIVE:To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN:Population based, prospective cohort study with follow-up over 15 years. SETTING:New South Wales, Australia. PARTICIPANTS:1642 men with localised prostate cancer, aged less than 70, an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m3503
更新日期:2020-10-07 00:00:00
abstract:OBJECTIVES:To identify the genetic determinants of fracture risk and assess the role of 15 clinical risk factors on osteoporotic fracture risk. DESIGN:Meta-analysis of genome wide association studies (GWAS) and a two-sample mendelian randomisation approach. SETTING:25 cohorts from Europe, United States, east Asia, an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k3225
更新日期:2018-08-29 00:00:00
abstract:OBJECTIVE:To accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DESIGN:Population based cohort study. SETTING:Population of Sweden using data from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3867
更新日期:2015-07-27 00:00:00
abstract:OBJECTIVES:To audit services for prenatal diagnosis for haemoglobin disorders in the United Kingdom. DESIGN:Comparison of the annual number of cases recorded in a United Kingdom register of prenatal diagnoses for haemoglobin disorders, with the annual number of pregnancies at risk of these disorders, by ethnic group a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.315.7111.779
更新日期:1997-09-27 00:00:00
abstract:OBJECTIVE:To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN:Cluster randomised controlled trial over 20 weeks. SETTING:Family compou...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.38512.618681.E0
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7060.784
更新日期:1996-09-28 00:00:00
abstract:OBJECTIVE:To describe the experiences of authors of Cochrane reviews in searching for, getting access to, and using unpublished data. DESIGN:Cross sectional study. SETTING:Cochrane reviews. PARTICIPANTS:2184 corresponding authors of Cochrane reviews as of May 2012. MAIN OUTCOME MEASURE:Frequencies of responses to o...
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pub_type: 杂志文章
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更新日期:2013-04-23 00:00:00
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journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.304.6829.746
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.316.7124.17
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abstract::The meaning of the GP contract has changed since the last major upheaval in the mid-1960s. The government has always dealt with general practitioners as independent contractors, but the way in which it treated them in 1990 was entirely different from the way in which they were treated in 1966. In 1966, the profession'...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7084.895
更新日期:1997-03-22 00:00:00
abstract:OBJECTIVE:To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. DESIGN:Parallel group randomised controlled trial. SETTING:Primary health centre in a deprived, ethnically mixed inner city area. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7394.855
更新日期:2003-04-19 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2020-05-13 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:2010-10-26 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38033.896505.EB
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更新日期:2010-03-31 00:00:00
abstract:OBJECTIVE:To investigate whether paracetamol (acetaminophen) plus ibuprofen are superior to either drug alone for increasing time without fever and the relief of fever associated discomfort in febrile children managed at home. DESIGN:Individually randomised, blinded, three arm trial. SETTING:Primary care and househol...
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更新日期:2008-09-02 00:00:00
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更新日期:2003-09-20 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:2006-04-29 00:00:00
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doi:10.1136/bmj.b2225
更新日期:2009-06-16 00:00:00