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  1. Naidu J, Wong Zh, Palaniappan Sh, Ngiu ChS, Yaacob NY, Abdul Hamid H, et al.
    Asian Pac J Cancer Prev, 2017 04 01;18(4):933-939.
    PMID: 28545190
    Background and Aims: Patients with inflammatory bowel disease (IBD) are subjected to a large amount of ionizing
    radiation during the course of their illness. This may increase their risk of malignancy to a greater level than that due
    to the disease itself. In Caucasian patients with Crohn’s disease, this has been well documented and recommendations
    are in place to avoid high radiation imaging protocols. However, there are limited data available on radiation exposure
    in Asian IBD patients.We therefore sought to identify total radiation exposure and any differences between ethnically
    diverse ulcerative colitis (UC) and Crohn’s disease (CD) patients at our centre along with determining factors that may
    contribute to any variation. Methods: The cumulative effective dose (CED) was calculated retrospectively from 2000
    to 2014 using data from our online radiology database and patients’ medical records. Total CED in the IBD population
    was measured. High exposure was defined as a radiation dose of greater than 0.2mSv (equivalent to slightly less than
    ½ a year of background radiation). Results: A total of 112 cases of IBD (36 CD and 76 UC) were reviewed. Our CD
    patients were diagnosed at an earlier age than our UC cases (mean age 26.1 vs 45.7). The total CED in our IBD population
    was 8.53 (95% CI: 4.53-12.52). Patients with CD were exposed to significantly higher radiation compared to those
    with UC. The mean CED was 18.6 (7.30-29.87) and 3.65 (1.74-5.56, p=0.01) for CD and UC patients respectively. 2
    patients were diagnosed as having a malignancy during follow up with respective CED values of 1.76mSv and 10mSv.
    Conclusions: CD patients, particularly those with complicated disease, received a higher frequency of diagnostic
    imaging over a shorter period when compared to UC patients. Usage of low radiation imaging protocols should be
    encouraged in IBD patients to reduce their risk of consequent malignancy.
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