Non-Cochrane · aetiology · PM42071202
Cancer risk from low-dose ionizing radiation in dental imaging: A systematic review and meta-analysis.
Chadli Kawtar, Ousli Houda, Neani Houda, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-08522-0
Findings
39 findings
| Population | ||||
|---|---|---|---|---|
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Longstreth et al. 2004 | OR 1.47 [1.12, 1.93] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) | OR 1.50 [1.15, 1.95] GRADE not reported 16 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Parodi 2015 | OR 1.53 [1.15, 2.03] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Davis 2011 | OR 1.55 [1.19, 2.03] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Oral cancer | OR 1.40 [0.78, 2.52] Very low Downgraded: risk of bias, imprecision 1 study · 708 participants |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Ruder 2006 | OR 1.59 [1.30, 1.94] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Central nervous system tumors | OR 1.31 [0.89, 1.91] Very low Downgraded: risk of bias, imprecision, inconsistency 9 studies · 28343 participants |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Inskip et al. 1995 | OR 1.46 [1.11, 1.92] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Risk of bias stratum: Low risk of bias (JBI) | OR 1.68 [1.23, 2.29] GRADE not reported 7 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Exposure ascertainment: Self-reported exposure | OR 1.58 [1.14, 2.19] GRADE not reported 13 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Lymphoid cancer | OR 1.20 [0.71, 2.03] Very low Downgraded: imprecision 1 study · 573 participants |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Memon A et al. 2010 | OR 1.45 [1.11, 1.91] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Zhang 2015 | OR 1.47 [1.12, 1.93] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Risk of bias stratum: High risk of bias (JBI) | OR 1.56 [0.73, 3.37] GRADE not reported 4 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Lin 2013 | OR 1.56 [1.17, 2.08] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Salivary gland cancer | OR 1.60 [0.97, 2.63] Very low Downgraded: risk of bias, imprecision 1 study · 332 participants |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Thyroid cancer | OR 2.21 [1.63, 2.99] Low Downgraded: risk of bias 4 studies · 3092 participants |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Exposure ascertainment: Medical and dental records | OR 1.20 [0.82, 1.74] GRADE not reported 3 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Horn-Ross 1997 | OR 1.49 [1.13, 1.98] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Risk of bias stratum: Moderate risk of bias (JBI) | OR 1.29 [0.97, 1.71] GRADE not reported 5 studies |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Ryan et al. 1992 | OR 1.51 [1.14, 2.00] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Schildt 1998 | OR 1.51 [1.14, 2.00] GRADE not reported 15 studies |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Claus EB et al. 2012 | OR 1.46 [1.11, 1.92] GRADE not reported 15 studies |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Rodvall et al. 1998 | OR 1.54 [1.16, 2.04] GRADE not reported 15 studies |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Preston-Martin et al. 1989 | OR 1.49 [1.13, 1.97] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Han 2012 | OR 1.43 [1.10, 1.86] GRADE not reported 15 studies |
| Adults and children with cancer (cases) and cancer-free controls | Exposure to diagnostic dental radiography (conventional dental X-rays) | No dental X-ray exposure | Any cancer (all cancer types combined) Leave-one-out sensitivity analysis: omitting Wingren et al. 1993 | OR 1.46 [1.11, 1.91] GRADE not reported 15 studies |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Neta 2013 | HR 1.60 [1.11, 2.29] GRADE not reported 2 studies |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Thyroid cancer | HR 1.13 [1.01, 1.26] Low Downgraded: risk of bias 1 study · 75494 participants |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Huang 2014 (second entry, lymphoid cancer) Unresolved: the two extractors disagree on this row. | HR 1.19 [1.01, 1.40] GRADE not reported 2 studies |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Central nervous system tumors (CT scan exposure) | HR 1.54 [1.03, 2.29] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 194138 participants |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Nordenskjold 2017 | HR 1.20 [0.95, 1.52] GRADE not reported 2 studies |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Any cancer (all cancer types combined) | HR 1.24 [1.02, 1.50] GRADE not reported 3 studies |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Lymphoid cancer (CT scan exposure) | HR 1.90 [0.82, 4.40] Very low Downgraded: imprecision 1 study · 112086 participants |
| Adults and children | Exposure to dental radiography or head/facial CT scans | No exposure (unexposed cohort) | Any cancer (all cancer types combined) Leave-one-out sensitivity: omitting Huang 2014 (first entry, CNS tumors) Unresolved: the two extractors disagree on this row. | HR 1.25 [0.99, 1.58] GRADE not reported 2 studies |
| Adults and children | Cone-beam computed tomography (CBCT) of the dental or maxillofacial region | No exposure | Cancer Unresolved: the two extractors disagree on this row. | no estimate extracted No studies found 0 studies |
| Participants in cohort studies of dental or head radiographic exposure | Radiographic exposure (conventional dental X-ray or head CT) | No radiographic exposure | Any cancer (all cancer types combined) Exposure ascertainment: self-report (conventional dental X-ray) | HR 1.13 [1.01, 1.26] GRADE not reported 1 study · 75494 participants |
| Participants in cohort studies of dental or head radiographic exposure | Radiographic exposure (conventional dental X-ray or head CT) | No radiographic exposure | Any cancer (all cancer types combined) Exposure ascertainment: medical and dental records (CT scan) | HR 1.60 [1.11, 2.29] GRADE not reported 2 studies · 194138 participants |
| Dental patients (adults and children) | Cone-beam computed tomography (CBCT) exposure | No CBCT exposure | Cancer risk (any cancer) Unresolved: the two extractors disagree on this row. | no estimate extracted No studies found 0 studies |
Included primary studies 24
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Burch 1987 An exploratory case-control study of brain tumors in adults. PMID:3104645 | 1987 | this review only | not stated | not extracted yet |
| Claus 2012 Dental x-rays and risk of meningioma. PMID:22492363 | 2012 | this review only | Central nervous system tumors | not extracted yet |
| Davis 2011 Medical diagnostic radiation exposures and risk of gliomas. PMID:21466382 | 2011 | this review only | Central nervous system tumors | not extracted yet |
| Hallquist 1994 Occupational exposures and thyroid cancer: results of a case-control study. PMID:8358287 | 1993 | this review only | not stated | not extracted yet |
| Han 2012 Are frequent dental x-ray examinations associated with increased risk of vestibular schwannoma? PMID:23211211 | 2012 | this review only | Central nervous system tumors | not extracted yet |
| Horn-Ross 1997 Environmental factors and the risk of salivary gland cancer. PMID:9209856 | 1997 | this review only | Salivary gland cancer | not extracted yet |
| Huang 2014 Paediatric head CT scan and subsequent risk of malignancy and benign brain tumour: a nation-wide population-based cohort study. PMID:24569470 | 2014 | this review only | Central nervous system tumors (CT scan exposure); Lymphoid cancer (CT scan exposure); PM42071202-P3-O1; PM42071202-P3-O2 | not extracted yet |
| Inskip 1995 Medical diagnostic x rays and thyroid cancer. PMID:7563204 | 1995 | this review only | Thyroid cancer | not extracted yet |
| Lin 2013 Dental diagnostic X-ray exposure and risk of benign and malignant brain tumors. PMID:23406732 | 2013 | this review only | Central nervous system tumors | not extracted yet |
| Longstreth 2004 Dental X-rays and the risk of intracranial meningioma: a population-based case-control study. PMID:14983499 | 2004 | this review only | Central nervous system tumors | not extracted yet |
| Ma 2008 Low-dose medical radiation exposure and breast cancer risk in women under age 50 years overall and by estrogen and progesterone receptor… PMID:17616809 | 2008 | this review only | not stated | not extracted yet |
| Matthews 2013 Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million… PMID:23694687 | 2013 | this review only | not stated | not extracted yet |
| Memon 2010 Dental x-rays and the risk of thyroid cancer: a case-control study. PMID:20397774 | 2010 | this review only | Thyroid cancer | not extracted yet |
| Neta 2013 A prospective study of medical diagnostic radiography and risk of thyroid cancer. PMID:23529772 | 2013 | this review only | Thyroid cancer | not extracted yet |
| Nishi 1989 A case-control study of non-T cell acute lymphoblastic leukaemia of children in Hokkaido, Japan. PMID:2614325 | 1989 | this review only | not stated | not extracted yet |
| Nordenskjold 2017 Risk of Meningioma after CT of the Head. PMID:28809584 | 2017 | this review only | Central nervous system tumors (CT scan exposure); PM42071202-P3-O1 | not extracted yet |
| Parodi 2015 Chronic diseases, medical history and familial cancer, and risk of leukemia and non-Hodgkin's lymphoma in an adult population: a… PMID:25982034 | 2015 | this review only | Lymphoid cancer | not extracted yet |
| Preston-Martin 1989 Risk factors for gliomas and meningiomas in males in Los Angeles County. PMID:2790826 | 1989 | this review only | Central nervous system tumors | not extracted yet |
| Rodvall 1998 Dental radiography after age 25 years, amalgam fillings and tumours of the central nervous system. PMID:9813721 | 1998 | this review only | Central nervous system tumors | not extracted yet |
| Ruder 2006 The Upper Midwest Health Study: a case-control study of primary intracranial gliomas in farm and rural residents. PMID:17131948 | 2006 | this review only | Central nervous system tumors | not extracted yet |
| Ryan 1992 Amalgam fillings, diagnostic dental x-rays and tumours of the brain and meninges. PMID:1306734 | 1992 | this review only | Central nervous system tumors | not extracted yet |
| Schildt 1998 Oral infections and dental factors in relation to oral cancer: a Swedish case--control study. PMID:9696928 | 1998 | this review only | Oral cancer | not extracted yet |
| Wingren 1993 Determinants of papillary cancer of the thyroid. PMID:8213752 | 1993 | this review only | Thyroid cancer | not extracted yet |
| Zhang 2015 Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study. PMID:25932870 | 2015 | this review only | Thyroid cancer | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults and children | Participants of 20 case-control and 4 cohort studies (n=24 studies; 19 in meta-analysis, 415,887 participants) |
| Intervention | Exposure to diagnostic low-dose ionizing radiation in dental settings (conventional radiographs and CT scans) | Any dental X-ray (unspecified), full-mouth, panoramic, intraoral, bitewing, cephalometric, and head or facial CT scans |
| Comparison | Absence of dental X-ray exposure | No dental X-ray or CT exposure (controls or unexposed cohort) |
| Outcomes | Brain cancer, meningioma, thyroid cancer, leukemia, and other malignancies | CNS tumors (n=11 studies), thyroid cancer (n=5), lymphoid cancer (n=2), oral cancer (n=1), salivary gland cancer (n=1); breast cancer and others not pooled |
| Study designs | Cohort and case-control studies with adjusted risk estimates; no language restriction | Case-control (n=20) and cohort (n=4) studies; 16 case-control and 3 cohort studies pooled |
| Timing | Not specified | Cohort follow-up up to 37 years; exposure exclusion periods 2 to 10 years |