DR. MOHLER: CAT scans – A double-edged sword
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
Forty five years ago when I finished medical school, appendicitis was diagnosed by listening to the patient’s story and examining his abdomen. Today when I call the surgeon, the first question he asks is,”What does the CAT scan show?” There is no question that modern imaging technology has improved our diagnostic capabilities, but at what price?
One of the costs of radiation, particularly with CAT scans, is the future increased risk of cancer. It is now estimated that 1%-1.5% of all cancers in the U.S. are caused by CAT scans. For every 1,000 people who submit to a heart CAT scan for calcium (no science that the test is useful), one person gets an additional cancer. A recent British study showed that kids under age 15 years who underwent brain CAT scans were three times as likely to develop a brain tumor or leukemia as kids who did not have a scan.
The other concern is that the cancer-causing effects of radiation are cumulative. Other than for folks who work in radiology departments, rarely is anyone keeping track of ongoing radiation exposure. California now has a law mandating the documentation of the dose of radiation for all patients.
The Choosing Wisely initiative, that we have discussed in this column, was expressly developed because we U.S. physicians order too many radiologic procedures. The public education arm of that program urges you, the patient, to take a more active role in your own care.
When approached by your physician who wants you to have a CAT scan, ask the following:
• What is this CAT scan for?
• What condition are you worried about?
• How much radiation does it involve?
• What happens if I don’t do it now?
Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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