Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Radiation exposure is related to the rise of a lawsuit culture

Dr. Charles
Physician
July 15, 2013
Share
Tweet
Share

A study published in the British Medical Journal highlights the importance of carefully choosing which children should receive diagnostic CT scans.  As a diagnostic test, CT scans utilize ionizing radiation that can cause cellular DNA damage, increasing the risk of cancer.  Children who received a CT scan were 25% more likely to develop a cancer in 10 years after radiation exposure, according to a study of 11 million children in Australia, 700,000 of whom received a CT scan.

The absolute number of children developing a cancer was low, equating to roughly one excess cancer per 4,000 head CT scans performed.  Yet each one of the 608 “extra” cancers among these children is a deplorable, heart breaking outcome.   For each additional CT scan received, the risk went up by an additional 16%.

This study also found that increased risk persisted through all 10 years studied, and so presumably the higher risk of cancer continues into future years.  Current CT scanners use less radiation than older machines, so hopefully this 25% increased risk may be less in present times.

CT scanners are readily available, and provide a convenient and expeditious diagnostic tool.  In this study the average dose of radiation from the CT scans received was 4.5 mSV.  On average a person living in the UK is exposed to 2.7 mSV in an entire year, while in the US, thanks to heavy use of medical imaging, the average is above 6 mSV. A transatlantic flight from the UK to the US results in about a 0.07 mSV exposure.

So where does this lead us?  The study’s authors make some excellent conclusions:

Practitioners will increasingly need to weigh the undoubted benefits of CT scans in clinical practice against the potential risks to justify each CT scan decision. Fortunately, many radiologists are now aware of the risks, and technological advances have already allowed CT scan doses to be reduced below those used in earlier decades. However, decision tools to objectively assess the need for CT are still not used routinely—for example, minor head trauma or suspected appendicitis are often managed using CT, rather than by observation, ultrasound, or magnetic resonance imaging. Imaging for head trauma still accounts for most CT scans in children. It is timely to alert the wider community, as well as the non-radiologist physicians who order most CT scans, to the potential risks. All parties, including patients and families, need to work together to ensure that CT scans are limited to situations where there is a definite clinical indication, and where every scan is optimised to provide a diagnostic CT image at the lowest possible radiation dose.

The amount of radiation received by Americans seems to be directly proportional to the rise of a lawsuit culture in which doctors are forced to practice defensive medicine.

It would be interesting to hear a patient state about their child who has just sustained a head injury: “Doctor, I am not going to sue you.  But what I do want is for you to help make a decision about whether my child should have a CT of the head by using your best clinical judgement, as well as any relevant evidence-based guidelines.”   I would imagine the first sentence would cut the number of CT scans ordered in the US by half. The second sentence is admittedly stilted, but you get the idea.

At the very least parents should have an open discussion about radiation when diagnostic tests are ordered for their children, and depending upon the situation, and ultrasound or MRI should be considered.  Every cancer, especially in a child, is as bad as it gets in this already difficult life.

“Dr. Charles” is a family physician who blogs at The Examining Room of Dr. Charles and The Green Examining Room. 

Prev

Judiciously order CT scans to protect our children

July 15, 2013 Kevin 1
…
Next

Do corporate wellness programs work?

July 15, 2013 Kevin 1
…

Tagged as: Oncology/Hematology, Radiology

Post navigation

< Previous Post
Judiciously order CT scans to protect our children
Next Post >
Do corporate wellness programs work?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Dr. Charles

  • a desk with keyboard and ipad with the kevinmd logo

    The disturbing link between high fructose corn syrup and honey

    Dr. Charles
  • Why a Miracle Whip advertisement is offensive

    Dr. Charles
  • a desk with keyboard and ipad with the kevinmd logo

    Beware of that new car smell when shopping for a new car

    Dr. Charles

More in Physician

  • Mastering medical presentations: Elevating your impact

    Harvey Castro, MD, MBA
  • Marketing as a clinician isn’t about selling. It’s about trust.

    Kara Pepper, MD
  • How doctors took back control from hospital executives

    Gene Uzawa Dorio, MD
  • How art and science fueled one woman’s path to medicine

    Amy Avakian, MD
  • In a fractured world, Brian Wilson’s message still heals

    Arthur Lazarus, MD, MBA
  • Why being a physician mom is harder than anyone admits

    Cynthia Chen-Joea, DO, MPH
  • Most Popular

  • Past Week

    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
  • Recent Posts

    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Marketing as a clinician isn’t about selling. It’s about trust.

      Kara Pepper, MD | Physician
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education
    • Inside human trafficking: a guide to recognizing and preventing it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Earwax could hold secrets to cancer, Alzheimer’s, and heart disease

      Sandra Vamos, EdD and Domenic Alaim | Conditions
    • Why male fertility needs to be part of every health conversation

      Hoag Memorial Hospital Presbyterian | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
  • Recent Posts

    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Marketing as a clinician isn’t about selling. It’s about trust.

      Kara Pepper, MD | Physician
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education
    • Inside human trafficking: a guide to recognizing and preventing it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Earwax could hold secrets to cancer, Alzheimer’s, and heart disease

      Sandra Vamos, EdD and Domenic Alaim | Conditions
    • Why male fertility needs to be part of every health conversation

      Hoag Memorial Hospital Presbyterian | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Radiation exposure is related to the rise of a lawsuit culture
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...