Therapeutic radioiodine (I-131) exposure for differentiated thyroid cancer (DTC) ablation...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | RF-IATROGENIC-IODINE131-SECONDARY-PREVENTION |
|---|---|
| Тип | Тривожна ознака |
| Статус | переглянуто 2026-05-19 | очікує клінічного підпису |
| Хвороби | DIS-BREAST |
| Джерела | SRC-IARC-100D-IONIZING-RADIATION SRC-NCCN-BREAST-2025 |
Походження тривожної ознаки
| Визначення | Therapeutic radioiodine (I-131) exposure for differentiated thyroid cancer (DTC) ablation/treatment OR Graves' disease — cumulative doses ≥100 mCi (3.7 GBq) lifetime confer small-but-real increased risk of secondary malignancies. Strongest signal: leukemia (RR ~1.5-2.0 above population baseline; latency 2-10 years), salivary gland cancer (RR ~1.3-2.0; latency 5-15 years), breast cancer in females (RR ~1.2-1.4; lower-quality evidence, dose-dependent), bladder cancer (modest signal). Iodine concentrates in salivary glands + stomach + bladder during excretion; non-target dose drives secondary cancer signal. Risk modestly higher at younger ages of exposure (proliferating tissues more radiosensitive). Prevention- persona RedFlag (§20, v0.3 iatrogenic expansion). |
|---|---|
| Клінічний напрям | investigate |
| Категорія | other |
Логіка спрацьовування
{
"any_of": [
{
"finding": "iodine_131_cumulative_ge_100mci",
"value": true
},
{
"finding": "i131_therapy_dtc_completed",
"value": true
},
{
"finding": "i131_therapy_graves_completed",
"value": true
}
],
"type": "lab_value"
}
Нотатки
Prevention-persona RedFlag for I-131 therapeutic-dose lifetime cumulative exposure. Surveillance: CBC q12mo for leukemia signal (sensitivity modest); breast surveillance per general-population USPSTF unless additional risk factors; oral + salivary symptom awareness. Highest-impact preventive intervention is hydration + lemon-juice sialagogue during I-131 administration (reduces salivary gland uptake) — retrospectively non-actionable for prior exposure. STUB pending two-Co-Lead signoff per CHARTER §6.1 dev-mode.
Де використовується
Indications
IND-IATROGENIC-IODINE131-SECONDARY-PREVENTION-OBSERVATION- IND-IATROGENIC-IODINE131-SECONDARY-PREVENTION-OBSERVATIONIND-IATROGENIC-IODINE131-SECONDARY-PREVENTION-SURVEILLANCE- IND-IATROGENIC-IODINE131-SECONDARY-PREVENTION-SURVEILLANCE