Are CT scans setting kids up for cancer?

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stroke, doctor, brain, scan, istockphoto, 4x3
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(CBS/AP) Have doctors gone scan crazy? A new study reveals that soaring numbers of kids are getting CT scans in emergency rooms, raising fears that the radiation exposure could increase their risk for cancer down the road.

The number of ER visits nationwide in which children were given CT scans rose five-fold between 1995 and 2008, from about 330,000 to 1.65 million. Increases occurred at children's hospitals but also at general hospitals - which may be less likely than pediatric hospitals to use special CT protocols with kids to limit their radiation exposure, the study authors said.

The study "underscores the need for special attention to this vulnerable population to ensure that imaging is appropriately ordered, performed and interpreted," the researchers said, led by Dr. David Larson at Cincinnati Children's Hospital Medical Center.

The study analyzed annual government surveys on ER visits at non-federal hospitals nationwide, focusing on visits in patients under age 18. Results were published Tuesday in the journal Radiology.

The increases may be due to improvements in CT technology. Modern scanners create clearer images and are faster than older models, producing results in just seconds - a bonus for busy emergency rooms, Larson said.

But other factors likely contributed to the increases, and in some cases, overuse, including fear of lawsuits, which drives some doctors to order tests to avoid getting sued for a missed diagnosis.

"If you send a kid home (without a CT scan) and it turns out you missed an abnormality, not many juries are going to be sympathetic," Larson said. CT scans were most commonly used for children with head injuries, headaches or abdominal pain.

Dr. Marta Hernanz-Schulman, a pediatric radiologist at Vanderbilt University Medical Center, said the study illustrates the need to make sure imaging scans aren't used inappropriately in children. She is a founder of the Image Gently campaign, started in 2008 by an alliance of doctors seeking to raise awareness about ways to reduce children's exposure to medical radiation.

Dr. Steven Krug, emergency department chief at Chicago's Children's Memorial Hospital, said many institutions including his own have started using ultrasound to diagnose appendicitis in some kids with abdominal pain. Ultrasound images aren't as detailed as CT images, and children with uncertain results will still need CT scans, but he said the trend may help limit radiation exposure.

Parents, too, are becoming more aware and increasingly asking about the risks, instead of demanding a CT scan for every bump on the head, he said.

  • David W Freeman

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