OBJECTIVES:

Cases of esophageal carcinoma have been documented in survivors of esophageal atresia (EA). Children with EA undergo considerable amounts of diagnostic imaging and consequent radiation exposure potentially increasing their lifetime cancer mortality risk. This study evaluates the radiological procedures performed on patients with EA and estimates their cumulative radiation exposure and attributable lifetime cancer mortality risk.

METHODS:

Medical records of patients with EA managed at a tertiary care center were reviewed for demographics, EA subtype and number and type of radiological investigations. Existing normative data was used to estimate the cumulative radiation exposure and lifetime cancer risk per patient.

RESULTS:

This study included 53 patients with a mean follow-up of 5.7 years. The overall median and maximum estimated effective radiation dose in the neonatal period was 5,521.4 μSv/patient and 66,638.6 μSv/patient, respectively. This correlates to a median and maximum estimated cumulative lifetime cancer mortality risk of 1: 1,530 and 1: 130, respectively. Hence, radiation exposure in the neonatal period increased the cumulative cancer mortality risk a median of 130-fold and a maximum of 1,575-fold in EA survivors.

CONCLUSION:

Children with EA are exposed to significant amounts of radiation and an increased estimated cumulative cancer mortality risk. Efforts should be made to eliminate superfluous imaging.