High dose of X-ray radiations increases cancer risk for obese patients

Extremely obese people need a higher dose of radiation during X-ray examinations than people of normal weight, which increases their risk of cancer, a recent study suggests.

The study appeared in the 'Journal of Radiological Protection'. The University of Exeter and Musgrove Park Hospital, Taunton, led the study of more than 600 patients who had undergone surgery for weight loss.

The researchers found 630 patients with an available history of radiation dose in X-rays carried out between 2007 and 2015. The patients in the study had a body mass index of up to 50, indicating they were severely obese and nearly twice the weight they should be for their height. They had all undergone procedures such as the fitting of gastric bands, gastric sleeves or gastric bypasses.

The team found that obese patients received much higher doses of radiation during X-ray than normal weight people, which is necessary due to the increased amount of tissue to be imaged.

The study concluded that the overall risk of cancer caused by the extra radiation was more than double (153%) that of normal-weight people undergoing X-ray. However, the risk of cancer from X-ray is low. In 2015-16, 22.6 million X-ray procedures were carried out in England. Up to 280 cancers may have been related to X-ray related radiation dose. X-rays are recognised as saving countless lives by detecting abnormalities in the body.

"X-rays are an extremely important diagnostic tool, and radiographers do their utmost to minimise the risk to patients. However, our findings highlight the implications of increased radiation doses in severely obese patients. Although the risk of cancer from X-ray is very low, we urgently need more research in patients who are overweight and obese, so we can understand how to minimise doses in this group and feed into far more robust guidelines around radiation, in turn, to minimise that risk," said study author Karen Knapp.

To create an X-ray image, radiographers project radiation-ray photons through the body. The dose differs depending on the body part and the size of the patient. It takes a higher dose to project through an abdomen than a chest, and higher doses are needed for larger or more obese patients.

The radiation excites body tissue and potential harmful effects are linked to chance in the doses used in diagnostic imaging. However, the higher the dose, the more likely it is to cause damage to cells. For this reason, radiation doses are kept as low as reasonably possible and all imaging is only requested where it is needed.

However, currently, there are no guidelines on how to minimise radiation doses in obese patients.