TY  - JOUR
T1  - Commentary on an article by Dino Samartzis, DSc, et al.: “Exposure to Ionizing Radiation and Development of Bone Sarcoma: New Insights Based on Atomic-Bomb Survivors of Hiroshima and Nagasaki”
AU  - Turkelson, Charles M.
Y1  - 2011/06/01
N1  - 10.2106/JBJS.K.00288
JO  - The Journal of Bone & Joint Surgery
SP  - e65 1
EP  - 1
VL  - 93
IS  - 11
N2  - 
As the authors imply, the results of the study are likely to be of particular interest to individuals undergoing certain medical diagnostic procedures and those exposed to certain occupational hazards. In addition, the lay public often takes an interest in the topic of "radiation." In this context, it is important to note that bone sarcoma is relatively rare. This rarity poses certain methodological challenges that, in turn, suggest that the findings of the study need to be viewed with some degree of caution. The need for this caution is not the result of poor study design, improper data collection, or some other flaw in the conduct of this research. It is the consequence of studying a rare disease. In their study, the authors analyzed the nineteen cases of bone sarcoma that occurred among the 80,181 subjects who met the study's inclusion criteria. As a consequence of this small number of cases, the 95% confidence interval for the threshold radiation dose is wide—0.12 to 1.85 Gy—suggesting that the 0.85 Gy point estimate of the threshold might not be all that accurate. The same uncertainty can be seen with regard to the estimate of the excess relative risk of bone sarcoma; the best estimate of the excess risk is 7.5-fold per gray, but the 95% confidence interval extends from 1.34 to 23.14-fold. The lower bound represents a relatively small increase in risk, whereas the upper one represents a tremendous increase.

SN  - 0021-9355
M3  - doi: 10.2106/JBJS.K.00288
UR  - http://dx.doi.org/10.2106/JBJS.K.00288
ER  -