Psychosomatic Bias in Low-dose Radiation Epidemiology: Assessing the Role of Radiophobia and Stress in Cancer Incidence

Historical assessment of radiation effects at low doses (below 0.2 Sv) are generally the result of back extrapolation from higher doses, which are known to have a linear relation between risk and dose. There are multiple counter-examples, and some literature argues that a threshold, nonlinear, or even a beneficial effect (hormeisis) can occur from radiation below these doses. The common theme found in all of these studies stems from the traditional approach of correlating disease rates to stimulus and then effectively curve-fitting the result toward zero dose. What has not been considered in general are the personal stress levels of the exposed individuals due to fear of cancer from low doses. The increased levels of cortisol due to the psychological stress from fear or depression has been shown in the literature to increase cancer probability. The extent to which low-dose exposed individuals were highly fearful or stressed from the radiation exposure would then give rise to elevated cancer based on stress rather than a fundamental radiogenic mechanism. If the population under epidemiological study is aware of a potential historical exposure (no matter how small) and has then lived under stress from fear or depression due to that exposure, the psychosomatic effects will bias the epidemiology accordingly and so should be quantified and accounted for as done with the effects of smoking.Health Phys. 129(0):000-000; 2025.