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
48 Shares
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?

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

  • Lively communication in the service industry

    Deepak Gupta, MD
  • Reigniting after burnout: 3 physician stories

    Kim Downey, PT
  • Inside the grueling life of a surgery intern

    Randall S. Fong, MD
  • The shifting landscape of gastroenterology manpower and compensation

    Brian Hudes, MD
  • Surgical procedures for inpatients: Addressing socioeconomic urgencies

    Deepak Gupta, MD
  • I’m a doctor, and I almost died during childbirth

    Bayo Curry-Winchell, MD
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Ketamine for mental health conditions: What every primary care physician needs to know

      Carlene MacMillan, MD & L. Alison McInnes, MD | Meds
    • Physician autonomy and patient interactions in corporate health care

      Michele Luckenbaugh | Conditions
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • 1 in 4 attempt suicide: the persecution of autistic physicians

      Patricia Celan, MD | Physician
  • Recent Posts

    • Physician autonomy and patient interactions in corporate health care

      Michele Luckenbaugh | Conditions
    • PSA screening: What you need to know [PODCAST]

      The Podcast by KevinMD | Podcast
    • Vague criteria can lead to misdiagnosis and prison

      L. Joseph Parker, MD | Conditions
    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • Lively communication in the service industry

      Deepak Gupta, MD | Physician
    • Contemporary weight loss: Unveiling the quest for elusive elixir

      Osmund Agbo, MD | 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

CME Spotlights

From MedPage Today

Latest News

  • 'Not Clear If the Juice Is Worth the Squeeze': What We Heard This Week
  • Avoiding Male Doctors Is Not Discrimination. It May Be Risk Aversion.
  • What Is the 'Carrot Tan' Trending on Social Media? A Dermatologist Weighs In
  • Did Gabapentin Improve Post-COVID Olfaction?
  • Fentanyl Death Trends; Food Additives and Heart Disease

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Ketamine for mental health conditions: What every primary care physician needs to know

      Carlene MacMillan, MD & L. Alison McInnes, MD | Meds
    • Physician autonomy and patient interactions in corporate health care

      Michele Luckenbaugh | Conditions
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • 1 in 4 attempt suicide: the persecution of autistic physicians

      Patricia Celan, MD | Physician
  • Recent Posts

    • Physician autonomy and patient interactions in corporate health care

      Michele Luckenbaugh | Conditions
    • PSA screening: What you need to know [PODCAST]

      The Podcast by KevinMD | Podcast
    • Vague criteria can lead to misdiagnosis and prison

      L. Joseph Parker, MD | Conditions
    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • Lively communication in the service industry

      Deepak Gupta, MD | Physician
    • Contemporary weight loss: Unveiling the quest for elusive elixir

      Osmund Agbo, MD | 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...