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Título:
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CT scan exposure in Spanish children and young adults by socioeconomic status: Crosssectional analysis of cohort data
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Autor/a:
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Bosch de Basea, Magda; Espinosa, Ana; Gil, Mariona; Figuerola, Jordi; Pardina Solano, Marina Asunción; Vilar, José; Cardis, Elisabeth
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Notas:
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Recent publications reported that children in disadvantaged areas undergo more CT scanning
than others. The present study is aimed to assess the potential differences in CT
imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences
vary with different indicators or different time point SES measurements. The associations
between CT scanning and SES, and between the CT scan rate per patient and SES
were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to
determine whether particular SES dimensions were more closely related to the probability
of undergoing one or multiple CTs. Comparisons were made with indices based on 2001
and 2011 censuses. We found evidence of socio-economic variation among young people,
mainly related to autonomous communities of residence. A slightly higher rate of scans per
patient of multiple body parts in the less affluent categories was observed, possibly reflecting
a higher rate of accidents and violence in these groups. The number of CT scans per
patient was higher both in the most affluent and the most deprived categories and somewhat
lower in the intermediate groups. This relation varied with the SES indicator used, with lower
CT scans per patients in categories of high unemployment and temporary work, but not
depending on categories of unskilled work or illiteracy. The relationship between these indicators
and number of CTs in 2011 was different than that seen with the 2001 census, with
the number of CTs increasing with higher unemployment. Overall we observed some differences
in the SES distribution of scanned patients by Autonomous Community in Spain.
There was, however, no major differences in the frequency of CT scans per patient by SES
overall, based on the 2001 census. The use of different indicators and of SES data collected
at different time points led to different relations between SES and frequency of CT scans,
outlining the difficulty of adequately capturing the social and economic dimensions which
may affect health and health service utilisation.
This work was partly supported by the
European Community’s Seventh Framework
Programme (FP7/2007-2013) (https://ec.europa.
eu/research/fp7/index_en.cfm) [grant number
269912 - EPI-CT: Epidemiological study to quantify
risks for paediatric computerized tomography and
to optimise doses]. Complementary funding was
received from the Consejo de Seguridad Nuclear
(https://www.csn.es/home). M. Bosch de Basea
was the recipient of a fellowship of the Centro de
Investigacio´n Biome´dica en Red de Epidemiolog´ıa
y Salud Pu´blica (CIBERESP) (http://www.ciberesp.
es/) Instituto de Salud Carlos III (ES) for a short
stay abroad at Newcastle University. ISGlobal is
part of the CERCA Programme / Generalitat de
Catalunya (http://cerca.cat/). |
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Derechos:
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cc-by (c) Bosch de Basea et al., 2018
http://creativecommons.org/licenses/by/4.0/
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Tipo de documento:
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Artículo
Artículo - Versión publicada |
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Editor:
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Public Library of Science
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Compartir:
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