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Are Too Many Scans Endangering Patients' Lives?

Along with a rise in claims of defensive medicine and unnecessary medical testing has come a concern that certain medical tests could be causing a dangerous increase in radiation exposure among some patients. A new movement has begun in some hospitals to track the cumulative radiation exposure a patient receives as part of his or her electronic medical record. While most are doing nothing more than tracking exposure, it may be a step toward curbing over-testing in that it will show doctors when a patient has received multiple high radiation dose procedures over time. It may encourage doctors to be more judicious in ordering these potentially damaging tests.

Even the decision to track this information is drawing controversy. Some doctors are concerned that there is insufficient evidence to balance the potential risks of greater radiation exposure against the risks of not obtaining the test results they desire. The movement to track exposure is based on recent studies connecting medical imaging tests with increased cancer rates. One such study indicated that the roughly four million pediatric CT scans performed on the head, abdomen, chest or spine in a given year will lead to a projected 4,870 future cancers.

Such studies may obscure the fact that there is no agreed upon level of "safe" radiation exposure. There has not been a conclusive study indicating that 10 millisieverts of radiation is safe, but 50 is dangerous. The cumulative radiation number may help make doctors mindful of the dangers of unnecessary testing, but it does not inform a doctor about when a possibly beneficial exam should be delayed or avoided.

Medical tests should only be performed under certain conditions. If testing is being done to placate an unreasonable patient or to increase profits, that is a serious problem. If other tests can acquire the information the doctor is seeking without exposing the patient to radiation, those methods may be advisable if a patient has had numerous imaging scans in the past. Whatever the case, it is good for patients and doctors to be aware that radiation exposure has the potential to cause harm and should not be considered without a good reason.

Source: American Medical News, "Project tallies lifetime radiation from health scans," by Christine S. Moyer, 24 June 2013

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