Dose-effect relationship and estimation of the carcinogenic effects of low doses of ionising radiation: The Joint Report of the Académie des Sciences (Paris) and of the Académie Nationale de Médecine
Résumé
The aim of the Joint Report of the two French Academies is to discuss the validity of the linear non threshold dose-effect relationship (LNT) for assessing the detrimental effects of small doses such as those delivered by X-ray examinations (0.1 mGy to 20 mGy). The conclusion of the report is that extrapolation with LNT could greatly overestimate those risks and thus may have a detrimental effect for public health by discouraging physicians and patients from performing potentially useful radiological examinations (for example a mammography or a CT scan) when the risk appears to be too large. This conclusion against the validity of LNT is based on several types of data: 1 Epidemiology has not evidenced cancer excess in humans for doses below 100 mSv. 2 Experimental animal data have not evidenced a carcinogenic effect for doses below 100 mSv. Moreover, dose-effect relationships are very seldom linear; most of them are linear-quadratic or quadratic. A practical threshold or hormetic effects have been observed in a large number of experimental studies. 3 Radiobiology: LNT assumes that the genotoxic risk (per unit dose) is constant irrespective of dose and dose rate and thus that the efficacy of the two guardians of the genome, DNA repair and elimination by death of cells with DNA damage do not vary with dose and dose rate. This assumption is not consistent with a large number of recent radiobiological data, for example mutational effect and lethal effect vary (per unit dose). The second assumption is that a given DNA damage has the same probability of initiating a cancer irrespective of the number of other DNA damage in the same cell and in the neighbouring cells. This assumption is also non consistent with recent data and modern concepts of carcinogenesis in which the microenvironment and tissue disorganisation play an important role. The existence of a threshold dose in individuals or animals contaminated by radium or thorium shows that the irradiation of a cell surrounded by non-irradiated cells does not initiate carcinogenesis. It is the responsibility of the proponents of LNT to demonstrate the validity of these two assumptions in order to justify the use of LNT. The recent reports do not provide such demonstrations. Copyright © 2006 Inderscience Enterprises Ltd.
Mots clés
radioisotope
radium
thorium
article
cancer epidemiology
cancer risk
carcinogenesis
carcinogenic activity
cell death
clinical trial
computer assisted tomography
DNA damage
DNA repair
experimentation
fetus disease
France
genotoxicity
health hazard
human
ionizing radiation
irradiation
leukemia
liver cancer
low energy radiation
mammography
maximum allowable concentration
medical society
meta analysis
microenvironment
nonhuman
osteosarcoma
oxidative stress
physician
public health
radiation dose
radiobiology
radiodiagnosis
radiosensitivity
signal transduction
solid tumor
systematic review