por Diana Bradley
, Staff Writer | January 20, 2012
From the January 2012 issue of HealthCare Business News magazine
To scan or not to scan: risks and benefits
Unsurprisingly, in response to the negative publicity, many patients have become hesitant when it comes to getting CT scans.
“Because of a substantial increase in media coverage around medical radiation use and potential effects to the population, there is a generally heightened awareness which has resulted in individual patient concerns,” says Dr. Geoffrey Rubin, George Geller professor and chairman of radiology at Duke University.
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Although the media’s attack on CT was “painful” for the sector, Dr. Elliot Fishman, a professor at Johns Hopkins University, notes that it was a good wakeup call, prompting both vendors and providers to be more vigilant about dose levels. He also suggests more patients are beginning to understand that the scans’ positives eclipse the negatives.
“The chance of getting cancer from a CT scan is a theoretical risk – you are more likely to get into an accident on the way to the scan,” he says. “The way you have to look at it is the risk of not getting a CT scan far outweighs the risk of getting a CT scan.”
Accidents aside, exposure-risks associated with standard CT procedures differ depending on the patient’s age, gender and size, along with what part of the body is being scanned.
“In general, young people are most at risk and this gradually diminishes with age,” says Rubin. “Risks are relatively greater for scans of the neck, chest, abdomen or pelvis and less for scans of the head and extremities.”
Additional concerns include potential discovery of incidental findings that require subsequent medical evaluations but may not improve outcomes. And understanding the relationship between hospitalization decision-making and CT use has implications for policy and health care system costs.
The Journal of the American Medical Association published in November by Stanford researchers claiming patients who had high-resolution CT scans to check for heart disease ended up having far more invasive tests and follow-up procedures for a cost of $4,000 more per patient than those who underwent basic stress tests. The study did not determine whether those extra tests and surgeries translated into healthier outcomes.
CT scans can also help to reduce the length of time a patient spends in the hospital and provide a net overall reduction in the cost of care by making diagnoses immediately available – this decreases the likelihood of other tasks or invasive procedures being required to determine what is wrong with the patient.