AccScience Publishing / CP / Online First / DOI: 10.36922/CP026020001
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ORIGINAL RESEARCH ARTICLE

Contrast media hypersensitivity in oncology patients undergoing enhanced computed tomography: Risk stratification and nurse-led pre-procedural assessment

Lizhu Zhang1 ,  Dongqiang Guo1 ,  Hongli Liang1*
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1 Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, China
CP, 026020001 https://doi.org/10.36922/CP026020001
Received: 5 January 2026 | Revised: 13 March 2026 | Accepted: 17 April 2026 | Published online: 5 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

This retrospective study (n = 1,623) evaluated risk factors for iodinated contrast media (ICM)-induced hypersensitivity in oncology patients undergoing computed tomography scans, developed a risk-stratification model, and assessed the efficacy of a nurse-based pre-evaluation protocol. Patients from three hospitals were divided into an intervention group that received a nurse-facilitated pre-assessment (n = 812) and a control group that followed standard protocols (n = 811). The overall incidence of ICM hypersensitivity was 3.2%. Multivariate analysis revealed that lung cancer (odds ratio [OR] = 2.13) and recent chemotherapy (OR = 2.87) are significant independent risk factors. A newly developed risk stratification model incorporating these attributes categorized patients into low, intermediate, and high-risk groups, with hypersensitivity rates of 1.2%, 4.5%, and 7.8%, respectively. Furthermore, the nurse-based pre-assessment intervention significantly lowered overall hypersensitivity rates (1.8% vs. 4.6%) and moderate-to-severe reactions (0.2% vs. 2.0%) compared to the control group, offering notable protection particularly for high-risk subgroups. In conclusion, lung cancer and recent chemotherapy strongly predict ICM hypersensitivity in cancer patients. Implementing a risk-stratification model based on these factors, combined with a dedicated nurse pre-assessment protocol, significantly reduces hypersensitivity incidents and enhances imaging safety for this vulnerable population.

Keywords
Cancer patients
Iodinated contrast media
Hypersensitivity risk
Tumor subtype
Chemotherapy history
Nurse-led assessment
Multicenter retrospective cohort study
Funding
This study was supported by the Shanxi Provincial Science and Technology Strategic Research Special Project under the project titled “Research on constructing discharge management strategies for cancer patients based on mobile health under the background of digital transformation in Shanxi Province” with grant number (202304031401141).
Conflict of interest
The authors declare no conflicts of interest.
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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