Health News Review

Another in the excellent Associated Press “overtreatment” series. Excerpt:

“Americans get the most medical radiation in the world, even more than folks in other rich countries. The U.S. accounts for half of the most advanced procedures that use radiation, and the average American’s dose has grown sixfold over the last couple of decades.

Too much radiation raises the risk of cancer. That risk is growing because people in everyday situations are getting imaging tests far too often. Like the New Hampshire teen who was about to get a CT scan to check for kidney stones until a radiologist, Dr. Steven Birnbaum, discovered he’d already had 14 of these powerful X-rays for previous episodes. Adding up the total dose, “I was horrified” at the cancer risk it posed, Birnbaum said.”

Comments

Dr Wendy Sue Swanson posted on June 14, 2010 at 1:02 pm

This “overtreatment”is particularly important when it comes to caring for children. Children are at inherent risk–the effects of radiation are far more dangerous to a developing body and brain and may have long lasting effects. The Image Gently campaign http://www.pedrad.org/associations/5364/ig/ is a thoughtful, careful and nice guide to reducing radiation exposure in children. This is a resource for parents, pediatricians, radiologists and technicians administering CT scans.
In pediatrics, less is more.
The amount of radiation in a head CT scan is the equivalent of about 100-250 chest x-rays! Only get CT scans on children when absolutely necessary and talk with your doctor about using the lowest dose possible. Direct them to Image Gently if they have any questions.
Read more at my blog here: http://seattlemamadoc.seattlechildrens.org/guest-blog-image-gently-5-things-you-can-do/

Dana Vaughan posted on June 15, 2010 at 11:12 pm

In T.R. Reid’s film, “Sick Around the World”, he states that the Japanese get 3x as many medical scans as do Americans and he goes on to explain how Japan’s healthcare cost payment system makes scans far more affordable in Japan than in the U.S. This seems to contradict the above statement about Americans being the biggest consumer of scans. Where are the data coming from?

Gary Schwitzer posted on June 16, 2010 at 10:19 am

Dana,
I wrote to reporter Marilyn Marchione, who responded that the figure came from:
Radiology: Volume 253: Number 2—November 2009, page 527.
She also noted, “It could be that Japan is high in a particular category such as heart scans.”
Thanks for your interest and your scrutiny.

Gregory D. Pawelski posted on July 1, 2010 at 11:04 pm

The current issue of Oncology News International (June 2010, V 19, No 6) quotes a Duke University study of the use of high-tech cancer imaging, with one representative finding being that the average Medicare lung cancer patient receives 11 radiographs, 6 CT scans, a PET scan, and MRI, two echocardiograms, and an ultrasound, all within two years of diagnosis. A study co-author (Dr. Kevan Schulman) asks: “Are all these imaging studies essential? Are they all of value? Is the information really meaningful? What is changing as a result of all this imaging?”
Why is it that oncologists are so accepting of high tech, expensive imaging studies, yet so reluctant to consider the use of cell culture diagnostic tests? For one thing, clinical trials virtually always have time to disease progression as a primary endpoint. Without the imaging studies, one can’t get accurate time to progression data. So these are tests performed for the benefit of drug companies seeking new drug approval, for clinical investigators seeking contracts and publications, and for clinicians seeking an easy way to make clinical decisions (and, occasionally, seeking income enhancement).
In the absence of information provided by cell culture testing, oncologists have complete freedom to choose between a myriad of drug regimens. The proven basis on which they make these selections, by and large, is on the benefit a given regimen provides to the oncologist (or academic institution). Cell culture testing threatens this freedom of choice. There’s absolutely nothing in it for the oncologist or academic medical center (unlike, for example, imaging studies).