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Factors Associated With CT Scan Repetition in Pediatrics and Its Relationship With Cancer Risk: A Systematic Review

Tahani Al-Shangeeti1, Rozilawati Ahmad1, Salah A Alshehade2

  • 1Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Dose-Response : a Publication of International Hormesis Society
|April 24, 2026
PubMed

Insights

Pediatric CT scans are linked to increased cancer risk, especially with repeat scans. Guidelines are needed to balance benefits and radiation exposure risks for children.

Area of Science:

  • Radiology and Imaging
  • Pediatric Oncology
  • Radiation Epidemiology

Background:

  • Increasing use of pediatric computed tomography (CT) scans raises concerns about ionizing radiation exposure.
  • Comparison with non-ionizing imaging modalities highlights potential risks.
  • This review focuses on factors leading to repeat pediatric CT scans and their cancer risk association.

Purpose of the Study:

  • To systematically review factors contributing to repeat CT scans in children.
  • To assess the association between pediatric CT scans and cancer risk.
  • To inform the development of pediatric CT guidelines.

Main Methods:

  • Comprehensive literature search across Web of Science, Scopus, and PubMed.
  • Inclusion of 30 eligible studies.
  • Meta-analysis of five studies involving over seven million participants.

Main Results:

  • CT exposure significantly increased overall cancer risk (RR = 1.49).
  • Elevated risk observed for brain tumors (RR = 1.55); leukemia risk was less conclusive (RR = 1.23).
  • A dose-response relationship was evident: two or more CT scans significantly increased cancer risk (RR = 2.51) compared to one scan (RR = 1.07).

Conclusions:

  • Results underscore the necessity for practical pediatric CT guidelines.
  • Recommendations include performing CT scans only when clinically justified, using low-dose protocols, and considering non-ionizing alternatives.
  • Future research should focus on evidence-based recommendations balancing diagnostic utility with long-term radiation risks in pediatric imaging.
Abstract

Keywords:
CT scancancer riskcomputed tomographycumulative dosesmeta-analysispediatric radiationradiation exposuresystematic review

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