A recent study in the New England Journal of Medicine has found a significant link between radiation exposure and imaging procedures such as CT and PET scans. The use of such technologies has grown from just 3 million in 1980 to 67 million in 2006, and has contributed, some estimate, to upwards of 2% of fatal cancer cases— the risk rising from 1 in 1000 for adults to 1 in 500 in children.
Much of the problem seems to center around a general lack of awareness—studies have shown that there is little consumer understanding of the risks involved in being subject to such procedures. One such study, performed by the Journal of Pediatric Radiation showed that only 3% of patients knew of the risks associated with radiation exposure from CT scans; and while their use continues to rise, these methods contribute not only to greater radiation exposure, but to more expensive health care.
Federal law allows physicians to earn a profit from the use of imaging machines that they use, and as a Washington Post article noted early last year, the number of CT scans ordered grows when a physician has an associated financial interest. On a different note, Dr. Harlan M. Krumholz proffers that the use of CT scans is increasing because they have become part of our culture. “People use imaging instead of examining a patient; they use imaging instead of talking to the patient,” (New York Times, Study Finds Radiation Risk for Patients, August 27, 2009).
For these reasons, imaging technologies have become a common diagnostic tool even when they are not required. For example, it is becoming more common for doctors to order routine heart scans for patients, even when they do not experience symptoms associated with heart disease. As such, numbers suggest that as many as 50% of ordered scans could have been replaced by safer and less expensive modes.
Representative Kulik’s legislation, House 2118, An Act to Investigate the Use of Computed Tomography (CT) Scans in the Commonwealth, attempts to address the issue of overuse of imaging technologies by allowing the Department of Public Health to look into their use and instate guidelines for their appropriateness. It’s time Massachusetts began looking into scans.