In a wonderfully strongly-worded piece in the New York Times, Drs. Rita Redberg and Rebecca Smith-Bindman talk about the future physical harms of excessive CT scans now.
They state that 1 in 10 Americans undergo a CT scan each year. A study by the National Cancer Institute estimated that CT scans conducted in 2007 will result in 29,000 excess cancer cases and 14,500 excess cancer deaths over the lifetime of those exposed. The authors estimate that 3% to 5% of all future cancers may be caused by CTs.
Normally I rail against the scare tactics of the healthcare industry. However, this line of reasoning — though it could never be proven by a gold-standard randomized controlled trial just because of the practicalities of conducting such a study — feels more like justified comeuppance to use the healthcare industries scare tactics against it.
Everybody knows that CT scans are overused. The more difficult question is how to slow the tide given the U.S. cultural belief that early detection cures everything, especially when an expensive technology is used. This belief works on both sides of the doctor-patient relationship. Doctors are afraid of being sued for not ordering CT scans. Patients expect that technology will spare them from the frailties of the human condition including death itself.
If it takes cancer scares to reduce stupid waste in the U.S. healthcare system, it’s not an ideal pathway, but so be it. Maybe this is the best first step to get the country to consider that its healthcare system is nowhere near the best in the world.
Hurrah! Danger from CAT scanners has been known for a long time (each one, >miliserve exposure, increases ones lifetime risk of cancer). I have had patients who had NO risk factors (including young women) who’s specialist ordered cardiac CAT scan. With them and others, no protection(breast shields, no shields of other areas that are vital but not need in the evaluation). It’s very hard to change minds and old habits. JAMA & NEJM compaired 1 scan to living out side of Hiroshima after the bomb. A good test when indicated but Caution advised…..
Great.
Now we can be sued for malpractice by ordering and not ordering a CT.
Attorneys always find the indefensible.