THEIR popularity as efficient, relatively cheap, and quick medical diagnostic tools that produce 3D pictures may make it difficult for doctors to think outside the CT-scan. But for the extended welfare of their patients, especially pediatric ones, physicians should start exercising restraint when ordering the fast, souped-up scans that can deliver 50 to 100 times more radiation than conventional X-rays.
It took two medical physicists from Columbia University in New York to put health-care professionals on notice that millions of Americans are needlessly getting dangerous radiation from overuse of computed tomography, or CT, scans.
In the New England Journal of Medicine, Eric Hall and David Brenner suggest that because doctors dangerously underestimate the radiation risk from CT scans, they may be ordering far too many of them for everything from chronic headaches to kidney stones and other maladies.
The estimated number of CT scans in the United States has soared from three million in 1980 to about 62 million last year. The researchers said that doctors often view the scans in the same light as other radiologic procedures even though radiation doses are typically much higher with CT than the others.
Options like ultrasound and MRI (magnetic resonance imaging) are safer, the scientists say, because they don't expose patients to radiation.
Their study concluded that fully one-third of all CT scans ordered may be nonessential. And if that many CT scans can't be justified by medical need, they argue, "perhaps 20 million adults and, crucially, more than 1 million children per year in the United States are being irradiated unnecessarily."In a few decades, the authors warn, as many as 2 percent of all cancers in the U.S. could be due to radiation from CT scans given now. Some experts say that estimate is overly alarming but nevertheless agree with the need for restraint.
There is even more pointed concern when it comes to the use of scans on kids. The tests are often used to diagnose or rule out appendicitis even though children have a higher risk because their tissues are at least 10 times more sensitive to radiation.
The researchers also noted how easy it is for patients to accumulate multiple CT scans over the years in a fragmented medical system where prescribing doctors may be unaware of past scans ordered. When people want answers fast about a variety of potential problems, particularly in an emergency room, the benefits of a CT scan may frequently outweigh the risks.
And the CT researchers had no intent to scare people away who may need them. The tests have saved lives through speedy diagnosis.
But it is also evident that a dramatic growth in the use of CT scans in this country has brought with it an equally dramatic increase in exposure to radiation and the associated risks of radiation-induced cancer.
That information should make doctors - and patients - think twice about CT scans and question their radiation risks before proceeding with the tests. In this case, getting too much of a good medical procedure could be detrimental to your health in the long run.
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