Advances in medical imaging techniques are allowing doctors to detect hidden diseases and make ever more accurate diagnoses. But radiation safety experts at the International Atomic Energy Agency (IAEA) say that overuse of high-tech scanning procedures may unnecessarily expose patients to increased radiation levels.
Concern surrounds procedures such as Computed Tomography (CT) Scans because they deliver higher doses of radiation to patients in comparison to conventional X-rays (radiographs). It´s been estimated that the average radiation dose of one CT scan is equal to roughly 500 chest X-rays. And that can increase a patient´s lifetime risk of cancer, particularly if CT scans are repeated. The use of CT scanning has grown dramatically in recent years. This X-ray based procedure provides three-dimensional views of organs and blood vessels and represents unparalleled advances in terms of clarity of image, ease of application and patient friendliness. For this reason there is a growing tendency for more and more CT examinations to be carried out. But published reports in medical literature, for example the November 2007 New England Journal of Medicine, suggest that up to 50 per cent of all scans done today are questionable on the grounds of medical justification.
“The medical application of ionizing radiation is the fastest growing source of radiation exposure to human beings today,”
says Renate Czarwinski, Head of the IAEA´s Radiation Safety and Monitoring Section. “We acknowledge the great value of the new technologies, but want to ensure that each and every examination is justified. The radiation protection of patients is also important.”
According to the latest estimates of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), as many as four billion diagnostic X-ray examinations are carried out worldwide each year. According to a report in the New England Journal of Medicine (NEJM), in 1980, three million CT scans were performed in the U.S. By 2009, the number had exceeded 72 million, including four million on children. One reason for the increase is many doctors have purchased their own imaging equipment for their practices. This adds a financial incentive into the mix and sets the stage for overuse of the technology. Countless Medical Centers in the US offer a comprehensive, painless, noninvasive, head-to-pelvis examination of the body’s internal organs – including the brain, heart, liver, lungs, prostate, ovaries – for a $700 to $6000 fee that is often times not covered by insurance.
Total body scanning is based on a compelling premise: Find cancer or heart disease or a brain tumor at its earliest stage – before a patient feels any symptoms or a more conventional test can detect it – and the problem can be contained, reversed or cured. A computed tomography (CT) scan can detect calcified plaque in coronary arteries. And because this calcium-laced plaque is believed to be associated with the presence of heart disease, CT scans are being widely advertised and hyped at many medical centers. For healthy patients the knowledge that nothing serious is wrong conveys peace of mind in the form of a “clean bill of health.” But there’s one huge downside medical marketers fail to talk about: the test bombards the body with radiation. And a new study of the test’s radiation risk suggests CT scans trigger cancer.
Critics of the screening device – including prominent radiologists, health economists and officials at the Food and Drug Administration (FDA) – say that the practice of indiscriminately scanning healthy people is unproven, ill-advised and potentially dangerous. CT technology, they say, is far too imprecise to be used as a mass screening tool, even though it will inevitably find a few people with cancer or serious heart disease or a brain tumor.
Thomas B. Shope Jr., special assistant to the director of the FDA’s Office of Science and Health, said:
“There is no scientific evidence that whole-body scanning detects disease early or saves lives.”
The Food and Drug Administration warned in a statement published in 2002 against use of the whole body scan saying “At this time the FDA knows of no data demonstrating that whole-body CT screening is effective in detecting any particular disease early enough for the disease to be managed, treated, or cured and advantageously spare a person at least some of the detriment associated with serious illness or premature death.” Many medical associations including the American College of Radiology are cited by the FDA as saying that they do not recommend CT screening, which is not as common as diagnostic CT scans.
That means researchers don’t even know what, if any, real advantages there are to having the test.
But it is widely known, according the American Cancer Society (ACS), that ionizing radiation is a scientifically proven cancer-causing agent in human beings. Ionizing radiation is firmly established by epidemiologic evidence as a proven cause of almost every major type of human Cancer. Some of the strongest evidence comes from the study of medical patients exposed to x-rays, even at minimal dose-levels per exposure. “What’s not clear is whether these CT scans do more good than potential harm,” said Shope, a physicist, who worries that radiation exposure could increase the risk of developing cancer, especially in those who undergo repeated scans. Shope estimates that one total-body scan exposes a patient to the amount of radiation equivalent to 400 to 500 chest X-rays. It’s difficult to find a radiologist unaffiliated with a scanning center who believes whole-body tests are appropriate for people without symptoms.
The idea that you have a clean bill of health due to a CT Scan reading is fallacious and can give patients a false sense of security. A person can have terrible metabolic problems that are not detected by CT scan such as diabetes or hypertension, two of the leading causes of disability and death.
Another drawback, critics say, is inaccuracy, in the form of false negatives – the failure to find a significant problem – and false positives – the incorrect indication of a serious problem – which inevitably triggers further testing that can be risky and expensive. “We know from old studies of CT scans that the false negative rate is very, very high – without contrast,” noted Bruce Hillman, chairman of the radiology department at the University of Virginia School of Medicine. Contrast studies involve the injection of dye into a vein to sharpen images and aid diagnosis. Contrast is not used in whole-body scanning. And no one knows what the false positive or false negative rate is for total-body scanning, added Hillman, who chairs the American College of Radiology’s Imaging Network which analyzes screening technology, because it has never been studied, nor is it likely to be.
What is particularly troublesome about this technology is the enormous increase in diagnostic medical interventions to follow up on false negative test results. These tests can frequently cause far more harm than good. Just the stress from having to cope with a diagnosis of a potential cancer could be enough to move the body towards disease and away from health.
14,000+ Deaths Per Year Due to CT Scan Radiation Exposure
Just about everyone by now knows that X-rays can increase your risk of developing cancer. Now it’s time for people to realize that CT Scans cause cancer at an exponentially higher rate. CT scans deliver far more radiation than has been believed, and may contribute to 29,000 new cancers each year, along with 14,500 deaths. One study found that people may be exposed to up to four times as much radiation as estimated by earlier studies. While previous studies relied on dummies equipped with sensors, authors of the new paper studied more than 1,000 patients at four hospitals. Based on their measurements, a patient could get as much radiation from one CT scan as 74 mammograms or 442 chest X-rays.
Currently radiation safety experts are working together with manufacturers and IT specialists to develop a Smart Card designed to register how much radiation a person receives in the course of a lifetime. This is a very ambitious plan but the development of X-ray machines that provide the radiation dose delivered in different examinations, as well as advances in electronic medical record systems, should eventually allow for this data to be included in medical records and on the electronic health cards already carried by people in many of the world´s developed countries.
At the same time, procedures needs to be optimized by reducing the CT-related radiation dose or, where appropriate, replacing CT with alternative techniques such as ultrasound or Magnetic Resonance Imaging (MRI). Hospitals should use the smallest possible doses of radiation without affecting the clinical value of the examination or the procedure. There is evidence that optimization can reduce the radiation doses by about 20-70% in many situations. The IAEA applauds advances in imaging technology that provide increased medical benefits to large numbers of patients. But because of concerns about cumulative doses of radiation, its message is that every effort should be made to reduce any unnecessary exposure.
The concern to be proactive is certainly a noble goal. However, this can be far more effectively accomplished by following guidelines that will promote health, such as a proper eating plan, proper rest, and exercise.
Even if one were to find a cancer in the early stages with this technology, one is still left with the question of how to treat it. If one relies on traditional approaches, it is highly likely that the treatment could be worse than the disease, as is reflected by the fact that traditional medicine is currently the third leading cause of death in the US.
A highly recommend alternative is thermography for breast screening in particular, as well as other types of imaging. Thermographic screening is entirely safe, non-invasive, and brilliantly simple. This technology measures the radiation of infrared heat from your body and translates the information into anatomical images. There is no pressure or compression of your breasts, and no radiation. This imaging system can detect signs of breast cancer up to 10 years before either a mammogram or a physical exam.
If your doctor or other health care provider recommends a CT scan, mammogram or other imaging technique as either a screening tool or to diagnose a physical complaint, I strongly encourage you to explore all your options before agreeing to be radiated. Don’t trade your good health or a minor complaint for an increased risk of x-ray-induced cancer in the future.
“Unthinking respect for authority is the greatest enemy of truth.” – Albert Einstein
Control your own health and your destiny. Realize that doctors and experts alike are capable of making mistakes too. Educate yourself to make better informed decisions. Patients should be encouraged to become better informed about why a radiological examination is being performed. Does it involve ionizing radiation? If so, has the procedure been justified adequately after considering other examination options that utilize non-ionizing radiation? This is all the more important in the case of CT scans or when an examination is to be repeated. However, according to experts such as Christian Herold, Chairman, Department of Radiology, Medical University of Vienna and currently President of the European Society of Radiology, care should be taken that this does not result in a patient refusing a duly justified examination.