I just read a rather alarming article about the dramatic increase in radiation exposure from medical tests over the last couple decades. We get more medical radiation than people in any other country – in fact, half of the world’s advanced imaging procedures that use radiation are done in the US. And the average American’s radiation exposure from medical testing has grown sixfold in the last twenty years.
In 2004, my father was hospitalized for four months with serious peritonitis. He had several abdominal surgeries and several abdominal CT scans. At the time, my family questioned the radiation exposure from the scans, but the doctors told us that they didn’t have a choice – his situation was life or death at the time, and when weighed against an increased cancer risk 20 years down the road, the choice was obvious. Luckily, there has been no repeat peritonitis, and my father is still cancer-free.
A few weeks ago, my mother was working on the roof of their house and fell off. All she broke was her femur (a bad break, but not as bad as a neck or a skull, so we’re counting our blessings), but the ER docs needed to be sure nothing else was wrong. The paramedics brought her into the hospital strapped to a backboard, and before they would take her off the backboard, they did a CT scan of her neck along with several x-rays of her broken leg. We aren’t sure why the neck imaging was done with a CT scanner rather than an x-ray machine, but that was the option the ER docs chose.
I’m sure most families have similar stories. CT scans are used so often that I think a lot of patients just expect to get one if they go to the ER or to the hospital with pain or a potential internal injury. That’s not to say that they are bad – in a lot of cases, including my dad’s, they can help doctors save a patient’s life. But we need to remember that they are absolutely not risk-free.
I like the idea of a radiation medical record that tracks a patient’s total exposure to imaging radiation over a lifetime. If it’s easy for a doctor to glance at a computer screen and see that a patient has already had a significant exposure to radiation, the doctor might look for other options for the current testing needs. As with many of the improvements that need to be made in our patient care system, tracking radiation exposure requires a more uniform, completely electronic medical records system that would allow data to be easily shared between one provider and another.
Advanced medical imaging is not cheap, and the fact that Americans have more of it done than any other country is likely a factor in our health care being so much more expensive than it is in other developed countries. The realization that a couple decades from now, 2% of all cancers in the US might be due to CT scans we’re doing now ought to make both doctors and patients think twice before using them.
Health insurance companies could have an impact on the problem too, by increasing the review process needed before advanced imaging is approved. If an ultrasound could be used instead of an x-ray, or an x-ray instead of a CT scan, we could be saving money as well as preventing future cancers.