Think twice before irradiating

Regular readers know I have a thing against excessive medical imaging. Imaging can be a great tool but CT and PET scans expose patients to high levels of radiation. Repeated tests lead to cumulative exposure that exceeds the dose of nuclear power plant workers and can even approach and surpass the level of Hiroshima and Nagasaki survivors.

Writing in the New England Journal of Medicine (Elements of Danger — The Case of Medical Imaging) Michael S. Lauer MD cautions against over-reliance on medical imaging. There’s little evidence (outside of mammography) that the potential dangers of imaging outweigh the benefits. Often imaging results lead to the use of non-evidence based interventions, and there’s little to suggest patients are better off.

The dangers are real, however. Lauer cites another source indicating that 2 percent of cancers may be attributable to CT scans. Use of CT has continued to escalate, so that number may even be low.

One of the under-appreciated values of personal health records (PHRs) is that they can be used to help a patient determine their cumulative radiation dose. Scans are usually considered in isolation –making it easier for physicians and patients to discount the radiation impact of a single scan. But seeing the cumulative impact may give pause.

I hope so.

August 27, 2009

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