Trends in Medical Ionizing Radiation Exposure from Diagnostic Imaging in Saudi Arabia: A Retrospective Analysis of Computed Tomography Utilization, Population Dose Estimates, and Associated Cancer Risk (2013–2022)

A BSTRACT Background: The rapid expansion of diagnostic imaging infrastructure globally has resulted in substantial increases in population exposure to medical ionizing radiation, with computed tomography (CT) accounting for the majority of collective dose. Saudi Arabia has undergone accelerated diagnostic imaging growth under Saudi Vision 2030, yet national trend data on CT utilization, population dose, and associated cancer risk remain limited. This study characterized trends in diagnostic CT utilization, estimated population-level effective dose, and quantified associated lifetime attributable cancer risk in Saudi Arabia between 2013 and 2022. Materials and Methods: This retrospective cross-sectional study analyzed the secondary data from Saudi Ministry of Health facility statistics, WHO Global Health Observatory imaging infrastructure data, and published dosimetry studies. Annual CT examination volumes were estimated from scanner density and utilization rate data. Effective dose per examination was derived from published diagnostic reference levels. Collective and per-capita effective doses were calculated. Lifetime attributable risk of radiation-induced cancer was estimated using the Linear No-Threshold model with risk coefficients from the Biological Effects of Ionizing Radiation VII report. Data were analyzed by imaging modality, body region, sex, and age group.