On the basis of a cohort study of 904 exposed and 2021 unexposed persons during 1943-1960 (conducted by Sandler et al. in Maryland), the risk for all head and neck cancers combined was higher among persons who had received the treatment than among persons who had not. However, this finding was based on small numbers of cancers (three brain and one soft palate cancer) and was statistically significant only after categories were combined.

A cohort study of 2510 exposed and 2199 unexposed persons (conducted by Verduijn et al. in the Netherlands) did not document a statistically significant increase in head and neck cancers in the exposed group.

Current studies do not indicate substantial increases in risks for neoplastic or other disease among those who received NRI treatments.  Follow-up studies of the cohorts in Maryland and the Netherlands are under way.  The results of these studies will help to clarify whether NRI is associated with an increased risk of head and neck cancer. They will also provide information that is useful in determining whether additional studies should be conducted.

Because the diseases that could be associated with this treatment are rare and the treatment may confer a modest additional risk of those diseases, CDC does not recommend screening for all patients who received the treatment. However, physicians may consider performing thorough head and neck examinations of patients with a history of NRI treatments. In addition, physicians who provide care for patients born before 1960 with head and neck complaints should ask the patients whether they have a history of NRI or other head and neck radiation treatments. Persons who recall being treated or believe they were treated with NRI should inform their physicians of the exposure. Some patients who received this treatment will be worried about it, and need the reassurance that is offered by a thorough and caring examination.

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