Defensive Medicine Leads to Overuse
Drs. Brenner and Hall suggest that the rapid increase in CT usage represents a potential public health problem in the United States that should be proactively addressed. This is particularly important for children, who are more sensitive than adults to radiation exposure. The issue arises, for example, when CT scans are requested in the context of so-called defensive medicine, or when scans are repeated as a patient passes through different parts of the medical system. Compounding the issue, surveys suggest that the majority of radiologists and emergency-room physicians may not appreciate that CT scans are likely to increase the lifetime risk of cancer. Ultimately, the health care system, the doctor, and the patient (who can perhaps best track of the number of CT scans performed when dealing with multiple doctors) may have to share the burden of monitoring the appropriate dosage and number of scans.
Drs. Brenner and Hall suggest three strategies for proactively addressing the potential increased radiation risks associated with CT scans:
1. Reduce the CT-related radiation dose in individual patients.
2. Replace CT use, when appropriate, with other options that have no radiation risk, such as ultrasound or magnetic resonance imaging (MRI).
3. Decrease the total number of CT scans prescribed.
Drs. Brenner and Hall suggest in their papers conclusion that these strategies could potentially keep 20 million adults and, crucially, more than one million children annually in the United States from being irradiated unnecessarily. They stress, however, that in the majority of individual cases, the benefits associated with
|Contact: Alex Lyda|
Columbia University Medical Center