Factors Associated with CT-Scan Repetition among Pediatrics and its Relationship with Cancer Risk: A Systematic Review and Meta-Analysis Protocol

Abstract Background The use of CT scans in pediatric patients has been increasing annually, exposing them to higher doses of radiation compared to other imaging modalities. The primary concern is the potential increased risk of stochastic effects, particularly cancer. This systematic review and meta-analysis aim to identify the factors contributing to repeat CT scans in pediatrics and their association with cancer risk. Furthermore, the study aims to determine the relative risk of cancer incidence associated with repeated CT scans in pediatric patients, as well as to identify the major cancers associated with repeated radiation exposure from CT scans in children. Additionally, the relationship between radiation dose and various factors, including scanning protocols, CT parameters, and exposure dose will be investigated. Methods/Design: A comprehensive systematic review will be conducted by searching relevant databases such as PubMed, Web of Science, and Scopus for studies pertaining to CT scan repetition in the pediatric population and cancer risk. The search strategy will involve keywords such as computed tomography, CT scan, cancer risk, radiation exposure, pediatrics, and cumulative doses. The database search was performed between 2012 and 2022. Two independent reviewers will assess the studies and examine the reference lists of eligible studies for additional references. Data extraction will be performed using a standardized form, and qualitative analysis will be conducted to synthesize the findings of the systematic review after assessing the risk of bias. Discussion By conducting this systematic review and meta-analysis, we aim to enhance our understanding of the factors contributing to repeat CT scans in pediatrics and their relationship with cancer risk. The findings will contribute to improved knowledge in this area and may inform strategies for minimizing unnecessary CT scan repetition and reducing associated cancer risks in pediatric patients. Trial Registration: The International Prospective Register of Systematic Reviews (PROSPERO) CRD42022342579