Are CT Scans Worth The Cancer Risk?

Study Warns Scans May Cause 2% Of All U.S. Cancers In Coming Decades

(CBS/AP) 

However, others defended the data, which has been widely cited in other radiation studies.

“It's the best evidence we've got” on cancer risks, Lauer said.

Dr. Robert Smith, the American Cancer Society's director of screening, said the authors' estimate that 2 percent of future cancers may be due to CT scans “seems high.” But since cancers take 10 to 20 years to develop, “the ability to even observe that kind of an increase is going to be very difficult,” he said.

The authors stressed that they were not trying to scare people who need CT scans away from having them. In most cases, the benefits exceed the risks, especially for diagnostic scans.

However, using the scans to screen people with no symptoms of illness - like screening smokers for signs of lung cancer - has not been shown to save lives and is not currently recommended.

Many groups also condemn whole-body scans, often peddled by private practitioners in shopping centers as peace of mind to the worried well. Many of these centers are not accredited by the College of Radiology; only a third of all places that do CT scans in the U.S. are, although insurers are starting to require it for reimbursement, Moore said.

Many CT centers also are set up for adults and rarely image children, who need adjustments to limit dose and radiation risk, said Dr. Alan Brody, a radiologist at Cincinnati Children's Hospital Medical Center who wrote a report on the topic. He said parents should seek a center that often handles children.

Both doctors and patients need to be more aware of radiation risks and discuss them openly, Brenner and Hall said.

“We were astonished to find, when we were researching materials for this paper, how many doctors, particularly emergency room physicians, really had no idea of the magnitude of the doses or the potential risks that were involved,” Hall said.

Other studies found the opposite problem: Three out of 10 parents in one study insisted on CT scans instead of observing the child's condition for awhile even after they were told of the radiation risk, Brody said.

“This is what our patients want,” and they expect fast answers from doctors, he said.

The pressure is greatest for ER doctors who “are in a bind ... they have all these patients stacked up” and need to make quick decisions, Mettler said.

Future generations of devices using less radiation should help alleviate the concern, but these mostly are directed at the emerging field of heart scans, Lauer said.

“When we order a CT scan it just doesn't seem like such a big deal” but it should be, he said. “The threshold for ordering these tests is low and it's getting lower and lower over time, which means that the risks become potentially all that more important.”

[hanleymike]

Medical decisions always involve weighing the risks and benefits of a procedure or medication. CT scans that will potentially provide life saving information should not be avoided for fear of an assumed small increased risk of cancer. You can visit www.xrayrisk.com to calculate individual risk based on studies you have had.

[eggy1620]

A related article in USA Today stated that the study%u2019s authors came up with their prediction (2% of all cancer diagnoses, or 3 million over the next 30 years) based on data from researchers%u2019 interviews of WWII atomic bomb survivors. So, their guesstimate is based on data collected from senior citizens who were asked to remember details from a traumatic event that happened 62 years ago, and kinda sorta attempted to be separated from health effects that would have happened over 62 years without radiation exposure. Yeah, this reliable science.

[medcare72]

I enjoyed your article on CT Scans I have been a Registered Technologist for 35 years. I would like to see a follow up on this story the public is not aware of. That in twelve states that people performing imaging studies are not required to be Registered of licensed in any way and in some states where they are required to do limited studies this is not upheld. These people are hired off the street with no medical knowledge of medical terminology, anatomy or radiation. They are taught how to get through an exam and thats it. As a Technologist you finish a program and obtain a liscense through the ARRT (American Registry of Radiologic Technologist) and are required to obtain CEU''s in order to keep your Registration. As a technologist you live by a code of ethics. Those that are not registered I have seen get by with things that they should not it is not just a radiation issue as technologist we perform invasive studies etc. I live in Alabama which is one of the states that does not require a Registration. In this state you are required to be licensed to cut hair, do plumbing and electrical work but someone can radiate you inject you with contrast read your medical records doesn''t make since does it. There is a bill to improve this called the CARE bill. For further information on this check with the ASRT (American Society of Radiologic Technologist. You did a story years ago on 60 min. about mammography and it improved the standards please look into this and do a follow up story.

[allunknowing]

This is a Nanny-State worthy article if I''ve ever heard one. "Lets try to scare the public."

If there is one thing that causes cancer more than anything else, it''s smoking. The next biggest concern in the cancer causing world would be the Sun.

If you need a CT scan, by all means get one. If your doctor is offering you a CT scan because he''s practicing defensive medicine and scared of being sued, don''t get one, and have an Advil.

[juwboy]

All of us are exposed to whole-body radiation daily because every cell in our bodies contains hundreds of atoms of the radioactive isotope carbon-14.

The radiation-emitting decay of carbon-14 is used by archaeologists to determine the age of ancient objects of organic origin, including human remains.

[seekingsense]

In a recent trip to the dentist, I learned of a new scanner they use - instead of the old film-based 2-dimentional Xray, the scanner uses a cone shaped beam x-ray, it only uses brief exposures, and does a scan once around the patient, with the result a 3-D computer generated image,just like the CT scan discussed. The critical difference is that the old CT scanner uses a narrow beam, so it has to go around the patient many times (=more exposure). These new Cone Beam CT scanners are applicable for head/neck/EarNoseThroat/dental, as the detector & receptor rotate around the head; either upright or horizontal models available. Seems like they could replace many CT current uses, and drastically reduce risks. Difference in exposure is a factor of 100 to 1000 times more in an old CT scanner.

[alphaa10-2009]

Patients and Patient Families, Beware!

The medical community for the last decade has been blitzed by little-publicized, traveling "legal seminars"-- these professing to help medical professionals avoid litigation.

As innocent as that sounds, some the methods taught by the seminars are anything but defensive. They cause needless pain and suffering, and are based upon manipulation of patient expectations.

Here is how the methods work. Suppose a patient and his family rush to the hospital for a critical procedure. They are beside themselves with anxiety, and need all the hope and reassurance possible. While emotional comfort sounds like an easy mission for staff, not so fast-- medical professionals are now told, this is "bad medicine".
(See Part 2, below)

[alphaa10-2009]

Part 2-- Patients, Patient Families, Beware!
The attending physician or other managing professional is instructed to inform the patient''s family with a poor prognosis-- "I am sorry, but the outlook is not the best. We''''ll do what we can, of course, but it appears all four wheels have fallen off. It will be difficult."

What a blow to an anxious family! What a failure of the oath to do no harm! At hearing such a report, family members have been known to become ill, as a result. But as the seminar tells medical professionals, it is all to the good. They are given the following explanation--

"If you promise the moon, but deliver coal and ashes, you probably will be sued by angry relatives, regardless of the effort you made and difficulty of the case. If you promise little or nothing-- yes, even advise of the worst-- but deliver something, anyway, and maybe even the sun and moon, combined, you will be hailed as a miracle worker. Your fees will be received with gratitude, not scrutiny."

[alphaa10-2009]

Patients and Patient Families, Beware!

The medical community for the last decade has been blitzed by little-publicized, traveling "legal seminars"-- these professing to help medical professionals avoid litigation.

As innocent as that sounds, some the methods taught by the seminars are anything but defensive. They cause needless pain and suffering, and are based upon manipulation of patient expectations.

Here is how the methods work. Suppose a patient and his family rush to the hospital for a critical procedure. They are beside themselves with anxiety, and need all the hope and reassurance possible. While emotional comfort sounds like an easy mission for staff, not so fast-- medical professionals are now told, this is "bad medicine".
(See Part 2, below)

[alphaa10-2009]

medprezz said, "Consider not the amount of CT scans used, but of America''''s obsession with litigation of physicians that forces them to perform medical procedures..."
---
Your comment copies propaganda straight out of HMO public relations of 15 years ago, regurgitated in faulty chapter and verse. Unfortunately for you, the insurance and HMO campaign against attorneys was not true then, and is not true today.

The main driver of medical liability insurance premiums for general surgeons, obstetricians and internists, concludes a 2005 Dartmouth study, has little to do with litigation awards. The 20-25 percent liability premium increase seen in 2002, for example, cannot have come from awards that year. The jury award stats simply don''''t support it.

So where did the malpractice premium increase come from? The study''s lead author reminds us insurance is like any other industry. If investment income in 2002 for the insurance industry were disappointing, premiums would have to make up the difference.

Today, liability rates remain anything but transparent. But count on it-- insurers will charge what the market will bear, and blame somebody else for it.

Your bias against attorneys is utterly disingenuous. In practice, you do not actually oppose all attorneys and litigation, only other people''''s attorneys and litigation.

[alphaa10-2009]

Hospitals-- administrators and department directors alike-- labor under a new emphasis on profit. Consequently, routine medical procedures are remarketed to sell the public a "new product" at a higher price.

This remarketing has little or nothing to do with the practice of medicine, but as hospitals begin to turn away from their primary mission of healing (remember?) for the new mandate of profit, something must be hidden or compromised in patient care.

That "something" is patient safety, an increased risk of cancer.

Although CT scans have immensely valuable applications, their potential abuse soars at hospitals viewing their high-tech medical equipment as a major new source of revenue.

[d33pthroat1]

Frikking doctors!!

Many points in this article are accurate.

My wife went to a doctor because she had some stomach pain. That quack asked 2 simple questions like where the pain was and how long she had it. He then poked her stomach once and ordered a CT scan. Total time for the appointment = 3 minutes! And, this was during a normal doctor''s appointment - not an emergency.

Fortunately, we knew CT scans are not to be taken lightly, so we went to a second doctor. This doctor did a proper physical exam, asked her to do a harmless ultrasound and a stool test. He then prescribed some medicine. Pain was gone in a few days.

So, you can see that the first doctor was using the CT scan as a diagnostic crutch. He didnt want to spend the time to perform a proper diagnosis.

Even more disturbing is the fact that many doctors make a cut from the CT scanning centers based on the number of patients the doctors send their way. Many doctors end up ordering CT scans much too often to line their own pockets.

Like I said, frikking doctors!

[aheadofcrowd]

I''d hope at this point we all know that radiation CAUSES cancer?

The amount that people are exposed to with CT scans is incredibly high.

The amount of money doctors receive through it''s use is quite a large amount.

Figure it out.

[jsc211]

I have been saying for years that radiation from CT scans causes cancer. My son died at the age of 7 years old from Acute Myeloid Leukemia exactly 5 years after he received 6 CT scans in an eleven day period due to head trauma sustained in an automobile accident.
When an option, MRI should be used in place of CT.

[jw218389]

This article fails to address the difference between localized exposure to an extremity (arm, leg, knee, etc...) versus the whole body exposure to GAMMA radiation that was received by the citizens of Hiroshima and Nagasaki.

You are probably at a greater risk working as a flight attendent or pilot high in the stratosphere than you are from getting a CT scan of your leg...

It raises a good question though - Is this CT scan really necessary??

[feelfree1]

The photograph used for this article appears to be of an MRI machine, which has nothing to do with x-rays.

[otdky07]

If this country would actually have REAL medical liability reform, the number of CT scans would decrease. It''s all about covering your ***. It''s cheaper to order a CT scan than to hire a lawyer.

[me4prezz]

Also, MRI scans, magnetic resonance imaging, cannot be used on patient''s who have metal implants, such as knee replacements, hip replacements, pacemakers, pins and plates from fractures, because the magnetic in the MRI will cause severe burns. It is not for everyone and also more expensive than a CT scan.

Ultrasound are used for localized areas, such as specific sections of the abdomen, not the entire abdomen. They are limited and cannot be used with the level of certainty in many areas of the body as are CT scans. They are great for the things that they can be used for, but this article implies that doctors are holding out. There is a lot to this article that is missing, like MEDICAL DATA!

[me4prezz]

Do you understand WHY these doctors, ESPECIALLY the emergency room physicians order these CT scans?

Consider the scenario:
A patient comes in to the emergency room, via ambulance, after being in a motor vehicle accident. The ER physician understands that the patient is not seriously injured, but the patient is complaining of neck and back pain and later complains of abdominal pain. The ER physician performs CT scans of the chest, abdomen and pelvis and then x-rays on the the levels of the spine that the patient has complaints of. All are negative.

OR

The ER physician observes the patient, performs symptomatic treatment, and ensures that the patient has no broken bones and sends the patient home.

A few weeks, the patient has significant lower back pain and states that the car accident caused his pain and sues the emergency room physician, the hospital, and the paramedics for failing to diagnose his back ailment. The ER physician who performed those CT scans can VERIFY without a doubt that the patient had no such problems immediately following the car accident. The ER physician without doing them, cannot. Who will be sued and left with nothing?

Consider not the amount of CT scans used, but of America''s obsession with litigation of physicians that forces them to perform medical procedures, testing and imaging studies that ordinarily they woudl not need to perform to save themselves from losing their medical license or everything they have worked for.