I have ranted often in the past that the CT scan has become a default test when we are confused. We too often order CT scans rather than thinking or doing a careful history and physical exam.
This article reminds us that everything we do in medicine has both risks and benefits – Overuse of CT scans will lead to new cancer deaths, a study shows
"The articles in this issue make clear that there is far more radiation from medical CT scans than has been recognized previously," Dr. Rita F. Redberg of UC San Francisco, editor of the journal, wrote in an editorial accompanying the reports. Even many otherwise healthy patients are being subjected to the radiation, she said, because emergency rooms are often sending patients to the CT scanner before they see a doctor.
Whole body scans of healthy patients looking for hidden tumors or other illnesses are also becoming more common, even though they rarely find anything wrong. The irony is that, by exposing healthy people to radiation, the scans may be creating more problems than they solve.
CT scans, short for computed tomography, provide exceptionally clear views of internal organs by combining data from multiple X-ray images. But the price for that clarity is increased exposure to X-rays, which cause mutations in DNA that can lead to cancer. When the screening is used for diagnostic purposes, the benefits outweigh the risks, most experts agree, though the toll increasingly can't be ignored.
Food for thought!
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The amount of CT's my patients get in the ER drives me crazy. If we were really worried about cancer, we'd spend less time worrying about questionable mammograms at age 40 & more time worried about every pt with the slightest belly pain in the ER getting shipped off to CT before the ER doc even sees the patient. We'll have a spike in lymphoma/leukemia in 10-20 years from all this. The mantra in the ER has switched to first cover your butt. What ever happened to first do no harm.
"Do no harm" became inoperative when the first lawsuit was filed against a physician who did not obtain some test, any test, that in retrospect would have revealed a problem sooner. If the CT/MRI/invasive biopsy is obtained, the defendant physician will not be asked "Why did you not order the CT/MRI/biopsy when it would have saved the patient's life?" at the inevitable deposition. If it has not happened to you, it's just a matter of time. There is no way for the leukemia that is caused by the 2 decade prior CT to be traced back to the "offending" physician- it's a no brainer for the poor ER physician who has to process 50 patients before his shift is over.