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USA Today report on CT scans

CT scan radiation linked to cancers, deaths
USA TODAY

12-15-09

CT scans deliver far more radiation than has been believed and may contribute to 29,000 new cancers each year, along with 14,500 deaths, suggest two studies in today's Archives of Internal Medicine. One study, led by the National Cancer Institute's Amy Berrington de Gonzalez, used existing exposure data to estimate how many cancers might be caused by CT scans.

Another study in the journal suggests the problem may even be worse. In that study, researchers found that people may be exposed to up to four times as much radiation as estimated by earlier studies. While previous studies relied on dummies equipped with sensors, authors of the new paper studied 1,119 patients at four San Francisco-area hospitals, says author Rebecca-Smith Bindman of the University of California-San Francisco. Based on those higher measurements, a patient could get as much radiation from one CT scan as 74 mammograms or 442 chest X-rays, she says.

Young people are at highest risk from excess radiation, partly because they have many years ahead of them in which cancers could develop, Smith-Bindman says. Among 20-year-old women who get one coronary angiogram, a CT scan of the heart, one in 150 will develop cancer related to the procedure.

Not all doctors agree about those risks. Scientists have not yet determined whether low doses of radiation actually increase cancer risk or whether the risk rises only after exposure levels reach a certain threshhold, says James Thrall, chairman of the American College of Radiology.

He says it's also tricky to compare cancer rates between people who have had CT scans with those who haven't. People undergoing scans may have underlying health problems that predispose them to cancer, he says.

In many cases, CT scans can be lifesaving. In other cases, there's no evidence a CT scan is really better than other approaches, Smith-Bindman says. Up to one-third of all CT scans are unnecessary, according to an accompanying editorial by Rita Redberg, also of UCSF.

Doctors sometimes order CT scans for convenience because they don't have access to results at another facility, says Rosaleen Parsons, chair of diagnostic imaging at Philadelphia's Fox-Chase Cancer Center, who wasn't involved in the new studies.

She suggests that patients keep their medical records and ask doctors about alternatives that don't involve radiation exposure.

Patients also should ask if a facility has been accredited by the American College of Radiology, she says.

To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com




3 Responses
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895634 tn?1283989210
Here's a follow up response from the American College of Radiology

http://acr.org/HomePageCategories/News/ACRNewsCenter/StatementonRecentStudiesRegardingCTScans.aspx

Here is an exerpt that I think is worth emphasizing.


Patients should also keep a record of their X-ray history and before undergoing a scan, should ask their physician:

Why do I need this exam?
How will having this exam improve my health care?
Are there alternatives that do not use radiation which are equally as good?
Is this facility ACR accredited?  
Is my child receiving a “kid-size” radiation dose (for pediatric exams)?

Best to all,
Robo
Helpful - 0
895634 tn?1283989210
As a radiologist reading CT's, MRI's and Ultrasounds every day,  I see a lot of unnecessary CT scans particularly in young patients.  Whenever possible, I advocate for nonradiation imaging options.  However, CT is a great modality and yields much diagnostic information.  

Some docs order CT's as a CYA (cover you a**) measure, not considering the cancer that will show up 20 years later.  Most apply judicious use of ionizing radiation.  

You have to find a way to balance the need for diagnostic information against the small but real risk of inducing a future cancer (this is esp true for younger pts).

I believe the risk of inducing cancers is real and not easily calculated.  The choice of which modality is used is driven by the desired diagnostic information (indication), referring Dr and patient.  Many factors determine the right test; pt size, claustrophobia, contrast allergy, findings on other imaging studies etc.  Radiation exposure should be a part of the equation.

Whenever possible,  it is your right to ask your Dr. how the results of any diagnostic test will impact your treatment plan/algorithm.

I'm lucky insurance-wise and choose to be followed with MRI.  I'm also in the younger(?) HCV population at 41.

Happy Holidays to all!

Robo
Helpful - 0
Avatar universal
i have read that a CT scans radiation is equivalent to 500 X-Rays. It would be much better to have an MRI instead but insurance companies insist on a CT first then follow-up with MRI.
Helpful - 0
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