nuclear-news

Increasingly, we and many other experts believe that an important culprit may be our own medical practices: We are silently irradiating ourselves to death.

The use of medical imaging with high-dose radiation — CT scans in particular — has soared in the past 20 years.

Our resulting exposure to medical radiation has increased more than sixfold between the 1980s and 2006, according to the National Council on Radiation Protection & Measurements.

The radiation doses of CT scans (a series of X-ray images from multiple angles) are 100 to 1,000 times higher than conventional X-rays.

Of course, early diagnosis thanks to medical imaging can be lifesaving. But there is distressingly little evidence of better health outcomes associated with the current high rate of scans.

There is, however, evidence of its harms.
The relationship between radiation and the development of cancer is well-understood:

A single CT scan exposes a patient to the amount of radiation that epidemiologic evidence shows can be cancer-causing.  The risks have been demonstrated directly in two large clinical studies in Britain and Australia.

The American College of Radiology and the American College of Cardiology have issued “appropriateness criteria” to help doctors consider the risks and benefits before ordering a test.

And the insurance industry has started using radiology benefit managers, who investigate whether an imaging test is necessary before authorizing payment for it. ……..

Patients have a part to play as well. Consumers can go to the Choosing Wisely [www.choosingwisely.org] website to learn about the most commonly overused tests.

Before agreeing to a CT scan, they should ask:

■ Will it lead to a better treatment and outcome?

■ Would they get that therapy without the test?

■ Are there alternatives that don’t involve radiation, like ultrasound or MRI?

■ When a CT scan is necessary, how can radiation exposure be minimized?

Neither doctors nor patients want to return to the days before CT scans.

But we need to find ways to use them without killing people in the process.
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Rita F. Redberg is a cardiologist at the University of California, San Francisco Medical Center, where Rebecca Smith-Bindman is a radiologist. Their essay first appeared in The New York Times. http://www.peninsuladailynews.com/article/20140615/news/306159974/peninsula-poll-backgrounder-are-we-giving-ourselves-cancer-with-ct