Physicians, Patients Uninformed of CT Radiation

A new report has highlighted that both patients and their physicians do not really know how much radiation is generated by a computed tomography (CT) scan. It is considerably higher than most people realize.

One abdominal CT scan is comparable to 100-250 chest radiographs, investigators report in the May 2004 issue of the journal Radiology. One controversial article has attributed 2,500 deaths per year to CT scans in the United States.
Howard P. Forman, M.D., and coworkers from Yale University (New Haven, CT, USA; www.yale.edu) questioned emergency department (ED) physicians, patients, and radiologists to establish the awareness level concerning radiation dose and possible risks associated with CT scans. Only five of 76 patients (7%) stated that they were informed of the risks and benefits before undergoing a CT scan, and only 10 of 45 ED physicians (22%) reported illuminating those risks/benefits to their patients.

Almost half of the radiologists (47%) thought that a CT scan increased the lifetime risk of cancer, the data show, but a comparable belief was reported by only 3% of patients and 9% of ED physicians. Ninety-two percent of patients believed that the radiation dose of one CT scan to be no more than about 10 chest radiographs, the investigators reported, as did 51% of ED physicians and 61% of radiologists. Only 22% of ED physicians and 13% of radiologists (and none of the patients) had dose predictions in the correct range.

"Given the current debate about the possible increased cancer risk associated with diagnostic CT scans, we believed that it is important that the radiology community make current information regarding CT radiation dose more widely available,” wrote the researchers in the report.

Physicians are not sufficiently knowledgeable to answer their patients' questions about the risk/benefit ratio of CT scans, according to Dr. Forman. But he does not want to unduly frighten patients from having needed scans done; however, they should be properly informed.




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