CT Scans Projected to Result in 100,000 New Cancers in The US 62
A new study projects that CT scans conducted in 2023 may result in around 103,000 future cancer cases in the U.S. due to low-dose ionizing radiation. "[I]t would put CT scans on par with other significant risk factors for cancer, like alcohol consumption, at least at a population level," reports ScienceAlert. From the report: At an individual level, the theoretical chance of developing cancer from a CT scan is thought to be very minimal, if it exists at all, and patients should not be scared of undergoing these tests if they are deemed medically necessary. However, the number of CT examinations performed each year in the US has increased by more than 30 percent since 2007, and researchers suggest that unwarranted tests are exposing the population to unnecessary radiation. [...]
The anonymous data comes from 143 hospitals and outpatient facilities across the US, catalogued in the UCSF International CT Dose Registry. Using statistics from 2016 to 2022, researchers predicted 93 million CT examinations were carried out in 2023, on roughly 62 million patients. Based on the associated radiation risks, the team estimates that CT scans in 2023 may be tied to 103,000 future cancers. The findings have been published in JAMA Internal Medicine.
The anonymous data comes from 143 hospitals and outpatient facilities across the US, catalogued in the UCSF International CT Dose Registry. Using statistics from 2016 to 2022, researchers predicted 93 million CT examinations were carried out in 2023, on roughly 62 million patients. Based on the associated radiation risks, the team estimates that CT scans in 2023 may be tied to 103,000 future cancers. The findings have been published in JAMA Internal Medicine.
This is crazy (Score:5, Insightful)
> 93 million CT examinations were carried out in 2023
So the average person gets a CT scan every three years? Over 20 in their lifetime? That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
European countries do far fewer CT scans, with better health outcomes, although the numbers are rising, too.
Re: (Score:1)
That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
One guess is that it is a matter of a known risk in the present vs. a theoretical/statistical threat in the future.
I don't know what makes a good example. Maybe someone with severe injuries from an industrial accident that without precise information on broken bones and foreign objects the person could die, be left disabled, or require multiple surgeries and a lengthy recovery, versus less invasive procedures and a relatively short recovery with that information. Is that worth some small increase risk of
Re:This is crazy (Score:5, Interesting)
> One guess is that it is a matter of a known risk in the present vs. a theoretical/statistical threat in the future.
Maybe, but I think something different is at play. There is a legal risk of not doing imaging, in case something might be present that is not quite clear through the symptoms. Doing a CT scan mitigates that legal risk, because "everything has been done". There seems to be little legal risk in doing a CT scan, even if it has a significant chance of causing cancer (probably because the risk is diffuse, and the causality hard to prove, as you said).
> but it was prescribed because the risks are balanced by the benefits.
I very much doubt that, at least if you talk about medical risk. For the legal risk, yes, that seems to be the main reason.
And your argument assumes that people act rationally. Have you looked around recently? Where do you get that faith in humanity? :-)
Re: (Score:2, Interesting)
And your argument assumes that people act rationally.
Is it rational to drink when thirsty? Eat when hungry? Sleep when tired? People manage to act rationally on many things all the time, if they didn't then they'd be dead. When things aren't so simple then things can get fuzzy on what is the rational action. Especially when taking some immediate concern on the balance with a future concern, such as having another drink at a bar than going home to sleep because of work the next day. Or longer term issues like saving up for a house, getting an education,
Re:This is crazy (Score:5, Informative)
Can they get the same information with MRI? Likely not if there's metal in the body, like in my example of an accident victim.
16-slice CT scanners are the defacto choice for ER imaging. It's fast, and covers a lot and allows the radiologist reading the image to reconstruct the region of interest rather than relying on the scanner operator to image it properly. And you don't have to worry about pace makers or asking an unconscious patient about metal fragments in their body. Or an x-ray to check first
CT scans are literally just an axial scan of whatever part of the body needs to be viewed. Usually 1mm thick and contigous. Those scans are then reformatted to whatever region is of Interest.
CT scans are better for looking at bones, but soft tissue can be seen to a lesser extent and contrast agent can be used for some soft tissue Basically denser objests show up brighter becauseof being x-ray opaque
MRI is much better for soft tissue because it's exciting water (extreme over simplification) it's also considerably slower. MRI also requires the scanner tech look at a specific organ and scan it using the correct sequence. The tech also has tk be able to understand how to tweak settings to image properly. MRI scans are typically 8mm slices with a 2mm gap between each. It's also slower than CT so in some cases the patient needs to hold their breath for up to 30 seconds to properly image some areas. There's also the risk of someone bringing a ferrous object into an MRI room in an emergency situation. This can and has been deadly.
Re: (Score:2)
There's also the risk of someone bringing a ferrous object into an MRI room in an emergency situation. This can and has been deadly.
As someone who has done a bit of metal work I am concerned about embedded chips and shavings...
Re: (Score:1)
Re: (Score:2)
What's the best way to detect metal in the eyes? I don't have any of that other stuff, though I do still have silver fillings. It's on my long list of dental work to have done to get them all switched over to something else.
Re: (Score:1)
Re: (Score:3)
I have metal implanted in my body and I can have MRIs because it's MRI safe metal. MRIs and CTs image different types of tissue.
Re: (Score:2)
The real question is CT vs conventional x-ray. I wonder how many CTs are done for simple bone breaks that used to be adequately managed with 2 single xrays?
Re: (Score:2)
so why do we use it like candy?
It's faster and cheaper than an MRI. Cancer? Eh, that's your problem, not theirs.
Re: (Score:2)
How would it being cheaper factor into it from the caregiver's side? Isn't it more a question of insurances pressuring towards less costly procedures?
I would guess they calculated that the additional cancers are cheaper than putting them all in MRIs instead.
Re: (Score:1)
> How would it being cheaper factor into it from the caregiver's side? Isn't it more a question of insurances pressuring towards less costly procedures?
CT is covered by insurance, MRI is not. An MRI tends to be about 3 to 5 more expensive.
"Would you like to pay out of pocket?"
> I would guess they calculated that the additional cancers are cheaper than putting them all in MRIs instead.
Not at all, but the cancers is "somebody else's" problem.
Re: This is crazy (Score:2)
I have had both CT and MRI, always covered by insurance. Not sure why they wouldn't be, if deemed medically necessary.
Re: (Score:2)
Mine are too, I have MRIs of my back and neck every year or two. It's not about cost, its about using the right tool for the situation.
Re: (Score:2)
so why do we use it like candy?
It's faster and cheaper than an MRI. Cancer? Eh, that's your problem, not theirs.
It not only is not their problem, but is a source of profit to them if whatever treats you gives you a new problem. This already happens with prescription drugs, the number three killer. They don't want to kill you, because that removes you from potential profit, but some of us might die, but that's a risk they are willing to take.
Re: (Score:2)
> 93 million CT examinations were carried out in 2023
So the average person gets a CT scan every three years? Over 20 in their lifetime? That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
Because hospitals have the machines, and they have to recoup their investment by charging for their use. That's only half sarcasm.
IMO, with the exception of time-critical scans (e.g. someone having a stroke, bowel obstruction, or other life-threatening emergency) and scans of people with metal implants, CTs really shouldn't even be used anymore.
At this point, the latest MRI tech (11.7T), has roughly reached parity with CTs in spatial resolution, and MRIs have always been better at contrast (distinguishing
Re:This is crazy (Score:5, Insightful)
> Instead, for some reason, a lot of doctors insist on doing it the other way around. This makes no sense at all to me. We should spend money to upgrade MRI hardware to be the best it can be, and stop using these ionizing-radiation-spewing abominations faster than 1950s shoe salesmen did.
That is exactly how I see it, but as you said, it is not happening. And yes, there are some applications where CT is certainly better (or where an MRI is disqualified because of implants), but you would assume those to be rare.
Re: (Score:3)
between "$300 and $6,750" for average cost of a CT scan... they are literally incentivized to do as many as possible. The joys of a healthcare system fueled by profits and not results. .... which also has the perverse result of causing conditions that will require additional CT scans... ... plus insurance companies declining procedures, needing a 2nd opinion- which results in additional scans ... google powered patients thinking they know better requesting doctors run the scans ... there are many many caus
Re: (Score:2)
What you're saying is not reality. I've had to have a bunch of MRIs of my neck and back, but I've only had 2 CTs in my life. One was in the ER and there was no way I could lay flat long enough to have an MRI, the CT was bad enough and it was over in a few minutes.
Re: (Score:1)
That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
Almost all bad things with anything medical related in the US can be explained by two industries and their interplay:
- The health insurance industry.
- The litigation industry.
There is also the health care industry, but it is greatly overshadowed by the two above.
Or, in other words, there is money to be made by someone. That someone is not you, the individual, just to be clear. Also, your health is not overly important. What is important is that you remain alive for as long as more money can be squeezed (dir
Re: (Score:2)
I'm currently undergoing radiation treatment for head & neck cancer. They did a CT scan on me before treatment started to get a good image of everything. I get 7 weeks of daily (weekdays) radiation, before each of which they do "mini CT" to make sure that I'm positioned properly in the machine. They'll do another at the end of the treatment. That's 37 CT scans in the span of about 2 months.
Re: This is crazy (Score:3)
I'm sorry you're fighting cancer. Best of luck to you.
I think your example is why these number seems crazy at first blush. 90 million CT scans is an average of 1 in 4 Americans getting a CT scan. That's not reasonable. But of course it's not a normal distribution, it's one thats heavily skewed by people with serious health conditions for which CT scans are providing a benefit, and could die of other causes (or maybe cancer) if they didn't get the CT scans.
By this argument, one could say that chemotherapy is
Re: (Score:2)
Cancer patients are probably what have inflated the number of CTs. The headline is clickbait.
Re: (Score:2)
I'm currently undergoing radiation treatment for head & neck cancer. They did a CT scan on me before treatment started to get a good image of everything. I get 7 weeks of daily (weekdays) radiation, before each of which they do "mini CT" to make sure that I'm positioned properly in the machine. They'll do another at the end of the treatment. That's 37 CT scans in the span of about 2 months.
Hoping it all works out for you, bro.
Re: (Score:1)
Mod this up. 37 scans in 2 months for cancer treatment, I had no idea. This definitely colors the story differently.
Re: This is crazy (Score:3)
Some people need repeat scans to track progress of their injuries and diseases and as follow-ups after treatment.
Re: (Score:3)
That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
They also don't just scan one area. I had to get a CT scan of my abdominal aorta. As I walked out, there was everything on the screen. Brain. Testicles. Everything in between. Why? Is the machine not capable of limits? Did they just get an order of "Do a scan" without some direction of what the doc wanted to see?
Re: (Score:2)
I usually make a jokes about "Death by compliance", about the number of useless "complicance documents" my company makes me sign every few months. 100% for CYA reasons and no real value.
My guess is this is the same. They order tests just to leave a paper trail that you were actually tested, so you can't sue them for not testing you.
This is literal Death by compliance.
Re: (Score:2)
Re: (Score:2)
> 93 million CT examinations were carried out in 2023
So the average person gets a CT scan every three years? Over 20 in their lifetime? That is crazy - the risk of a CT scan is pretty well understood, so why do we use it like candy?
European countries do far fewer CT scans, with better health outcomes, although the numbers are rising, too.
I think the main reason is that once a hospital or lab purchases expensive equipment, they try really hard to amortize the cost of the equipment across as many patients as possible. The amortization motivation outweighs the good to the patient. I remember some years ago being pressured by my optometrist to get a $75 retina scan. She had just bought this expensive machine and needed to pay for it. Of course, she didn't say it that way. Instead, she said that having to pay the $75 out of pocket was worth
Impressive statistics but... (Score:3)
Re: (Score:1, Troll)
How many of the projected new cancer cases involve patients with old age or pre-cancerous conditions that would have evolved into cancer anyway due to other factors? Statistics are hard to read.
Be careful. You’re starting to sound like a litigator prepping for the defense on behalf of those profiting immensely off CT scans. And cancer.
Best we really follow through with this study. It’s a disgusting enough theory within the Cancer Industrial Complex. Those who profit heavily off treating cancer, are also prescribing the very tests that are now suspected of giving you cancer? Yeah, we definitely need to know more here.
Re: (Score:2)
Re: (Score:2, Flamebait)
Actually, I find these statistics very easy to read. 100 000 additional cancer cases, every year, most of them avoidable. And the risk of ionising radiation is very well understood.
How much easier do you want it?
Re: (Score:3)
Re:Impressive statistics but... (Score:5, Insightful)
"CT scans conducted in 2023 could be responsible for an estimated 103,000 future cases of cancer. That's based on some assumptions and historical data from high radiation events, but if right, it would put CT scans on par with other significant risk factors for cancer, like alcohol consumption, at least at a population level. "
"As of now, these are just theoretical risks, but that doesn't mean they aren't worth considering. While scientists know that high doses of radiation cause cancer, conclusive evidence to link low-level radiation to cancer is lacking."
"The potential association is mostly based on long-term studies of atomic bomb survivors and those exposed to nuclear power plant meltdowns. For instance, in a group of 25,000 Hiroshima survivors, who received a dose of ionizing radiation on par with three or more CT scans, there was a slight but significant increase in cancer risk across a lifetime."
""Any risk from a CT scan of a sick patient is likely much less than the risk of the underlying disease," says Cynthia McCollough, CT imaging expert and past president of the American Association of Physicists in Medicine. In a large national trial, there was a 20 percent decrease in lung cancer deaths among smokers and ex-smokers who received low-dose CT scans compared to those who only had a chest X-ray."
So reading the article and the paper, this appears to be a calculated, estimated risk based on assumptions that aren't well proven (the link of low dose ionized radiation) about a method of diagnostics that has resulted in a 20% decrease in lung cancer deaths, a known and proven benefit. That's a far cry from "avoidable", and the there is in fact debatable evidence that low dose ionizing radiation does anything harmful [nih.gov] given we're exposed to that radiation on a daily basis in very low doses already.
Re: (Score:2)
The article sucks. It adds a lot of "debated", "potential, "theoretical" nonsense etc. to it. I do not see this in the actual scientific article. And as a full professor of medical imaging, I can tell you that nobody in the field rarely doubts the low-dose effects or radiation. This is very clear from the physics and also from large scale studies which demonstrate this effects even for CT. There is certainly a lot of uncertainty, but not really a debate about the fundamental question. Having said this, th
Re: (Score:3)
That's why we rely on scientists who know what they are doing and publish papers in peer reviewed journals where their results are judged to tell us what the results are. They typically provide more correct results than a random Slashdotter who thinks they are more qualified than actual people working in the field of research.
Re: (Score:2)
Kids. Just say no to CT scans (Score:2)
A grim joke (Score:2)
Risk model from anonymous data...... (Score:2)
Re: (Score:2)
This small animal model of space flight suggests that the combined effects of radiation and virus replication will significantly affect T-lymphocyte–mediated immunity that may lead to chronic viral infection and malignancy https://www.sciencedirect.com/... [sciencedirect.com]
Reactivation of several latent viruses in astronauts is well documented, although the mechanism of reactivation is not well understood. We studied the effect of four different types of radiation, (1) 137Cs gamma rays, (2) 150-MeV protons, (3) 600 MeV/n carbon ions, and (4) 600 MeV/n iron ions on the activation of lytic gene transcription and of reactivation of EBV in a latently infected cell line (Akata) at doses of 0.1, 0.5, 1.0, and 2.0 Gy. The data showed that for all doses used in this study, lytic gene transcription was induced and median viral loads were significantly higher for all types of radiation than in corresponding control samples, with the increases detected as early as four days post-exposure and generally tapering off at later time points. https://www.mdpi.com/1422-0067... [mdpi.com]
This study
Well Duhh People who Get CT Scans Have Cancer (Score:4, Insightful)
Note well: READ THE ARTICLE - and the paper (Score:3)
As of now, these are just theoretical risks, but that doesn't mean they aren't worth considering. While scientists know that high doses of radiation cause cancer, conclusive evidence to link low-level radiation to cancer is lacking.
The potential association is mostly based on long-term studies of atomic bomb survivors and those exposed to nuclear power plant meltdowns. For instance, in a group of 25,000 Hiroshima survivors, who received a dose of ionizing radiation on par with three or more CT scans, there was a slight but significant increase in cancer risk across a lifetime.
and
Whether those results extend to CT scans remains hotly debated, and the theoretical risks must be weighed against the myriad benefits of this technology, which can now alert patients and doctors to a whole variety of hidden diseases and injuries with very low doses of radiation (about the same amount you absorb from your environment over three years).
In other words, this study is mostly based on people who were exposed to ionizing radiation from (a) nuclear weapons and (b) nuclear power plants...which is NOT the same in quantity, composition, duration, or exposure method as the ionizing radiation delivered by CT scanners -- which, incidentally, have been progressively refined over multiple decades to use lower and lower energy beams.
As to the cited increase in the number of CT scans among the general population over the past ~20 years, there are two reasons for that: the medical one is that the use of CT data for diagnostic purposes has expanded in part because of the better quality of the scans and in part because more sophisticated and accurate uses of that data have been devised. The non-medical reason is: insurers. Insurers don't want to pay for MRI scans because they cost more, and this leaves clinicians and patients with a dilemma: do they try to find a way to argue the insurers into paying for the MRI (good luck with that) or do they fall back to CT, even though it may not be the optimal diagnostic tool? Note that in some cases, insurers will insist on a CT scan before they'll agree to pay for an MRI scan, which costs everyone more money and time and delays diagnosis and is largely a waste of time. But insurers are not concerned with this, only with maximizing profits.
I'm rather surprised that this paper made it past peer review. I think there's a significant possibility that it will be retracted at some point, but just as has happened in other cases, people will remember the alarmist headlines and not the retraction.
Something doesnt add up (Score:5, Insightful)
Large assumptions made. (Score:2)
CT scans conducted in 2023 could be responsible for an estimated 103,000 future cases of cancer.
That's based on some assumptions and historical data from high radiation events, but if right,
...
While scientists know that high doses of radiation cause cancer, conclusive evidence to link low-level radiation to cancer is lacking.
Publishers need to be more careful about publishing headlines like this because it has the ability to do far more harm than good.
So am I more likely (Score:3)
What's more risky in terms of death?
1) Riding a motorcycle daily or weekly.
2) Flying on an airplane weekly for your career.
3) Eating that Tuna sandwich from the corner store.
4) CT Scan.
5) Getting a chest X-ray.
6) Pulling a Lion or Tiger tail.
I've done 5 out of the six.
The gas-station mini-mart tuna sandwich (Score:2)
That one is a high-danger outlier on this list.
Re: (Score:2)
Re: (Score:2)
It was a cute little tiger cub. It tried to bite me.
So what I'm gathering is (Score:2)
Major Money Maker Unfortunately (Score:2)