Recently the dangers of CT scans have been all over popular news sites like NPR and The New York Times. A recent research paper has been published exposing the risks of CT scans resulting in increased risk of cancers, particularly leukemia, in children.
CT scans, or computed tomography, generate 3-D images from multiple 2-D X-Rays taken around a single point. The CT scan was introduced in the 1970s as a tool throughout the medical community to diagnose diseases and abnormalities of the soft tissue that a 2-D X-ray would not be able to discern. CT scans have the ability to show abnormalities in organs, muscles, nerves, tissues (as well as bones), through the use very precise, multiple imaging. Without CT scans it would be very difficult to diagnose early stage cancers, tumors, hemorrhages, strokes, head traumas, or embolisms.
A CT scan is considered a moderate to high radiation risk due to the multitude of X-Rays being taken of one location. This radiation exposure could be 10 to 100 times that of a normal X-Ray. Radiation risk is assessed based on location of the imaging, amount of radiation a person has been exposed to (previous CT, X-Rays, environmental exposures), patient age, patient build (a small child vs an NFL football player), and precision of desired image quality (discerning the border of a palpable tumor vs trying to locate a small cerebral aneurysm).
The research paper suggesting that CT scans create an increased risk of brain cancers and leukemias in children could create a fear based back-lash against this amazing diagnostic tool that could prevent the diagnosis of disease or injury. There are two critical points to remember in regards to this paper.
1. Leukemias are primarily a cancer of children. Suggesting that CT scans foster an increased risk of a cancer that already has a higher incidents in children that do not have CT scans is flawed researching. There is no way, based on the methodology of this paper, to prove that the children exposed to the CT scans would not have leukemia regardless. There are a number of variables to consider. The subject population in the research article were already a sick sample study. These children were included in the study because they had no prior cancer diagnosis but still received a CT scan before the age of 22. This does not account for any other variables that could increase the likelihood of cancer in this population. If anything, it should be more closely inspected because the sample population already had conditions warranting medical intervention.
2. CT scans are a diagnostic tool and not a toy. CT scans have been used in diagnostic medicine more and more frequently in incidents where simple X-Rays, bloodwork, or proper medical intakes would suffice. The Center for Radiologic Research published a paper critiquing the use of CT scans in asymptomatic patients and its relationship to cancers in all patient populations. This research paper suggests that 1/3 of ALL CT scans are unnecessary.
Perhaps it is due to the litigious nature of our society that physicians are using CT scans to diagnose conditions do not warrant the risk of exposure to radiation. Dr. Brenner, director of the Center for Radiological Research at the Columbia University College of Physicians and Surgeons, stated that “young people were often given CT scans to diagnose kidney stones, appendicitis and dental problems, and that some of those scans could have been avoided by using other methods, like ultrasound or conventional X-rays.”
Ultimately, throwing such a revolutionary and invaluable diagnostic tool “under the bus” by using buzz words and headlines creating a fear based environment that CT scans are increasing cancers in children is bad reporting, bad science, and bad press. Unnecessary CT scans are exactly that, unnecessary, and not without their risks. However, it is the invention and implementation of CT scans that will save the lives of young children who would die without the advantages of modern medicine in the diagnosis of many conditions.
When treating my patients I put great emphasis in a thorough medical evaluation with an exhaustive medical history. A good medical history by a trained medical practitioner will steer most patients in the direction of health and well-being. A great medical history will determine whether or not further diagnostic tools are required. It is important in the medical community that physicians do not become complacent in connecting with and listening to their patients. CT scans are not a replacement for good traditional medicine, they are a supplement when more investigation and other diagnostic tools have been exhaustive.
