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Informational handout key to giving parents a better understanding of CT radiation risks

Simply giving parents informational handouts can improve their understanding of the potential increased risk of cancer related to pediatric CT, according to a recent study conducted by researchers from The Childrens Hospital in Denver, CO and Yale University School of Medicine in New Haven, CT.

Like many radiology departments around the country, we are concerned about the increasing radiation exposure to children caused by increased usage of CT. When we looked into it, our emergency physicians told us that parents' expectations may play a role, said David B. Larson, MD, lead author of the study. The emergency room clinicians tell us anecdotally that a number of parents expect that their child will undergo CT even before the child is seen by a physician. Parents rarely seem to understand the associated risks, so we thought it might be helpful to our emergency room colleagues to provide a handout to parents to explain, in basic terms, the risks associated with CT, said Dr. Larson.

The study consisted of 100 parents of children undergoing non-emergent CT studies who were surveyed before and after reading an informational handout that described radiation risks. Of the 100 parents surveyed, 66% believed that CT uses radiation; 99% afterwards. 13% of those surveyed before reading the handout believed CT increases the lifetime risk of cancer, versus 86% surveyed afterward.

According to the study, after reading the handout, parents became less willing to have their child undergo a CT examination if their doctor believed that either CT or observation would be equally effective. Their willingness to have their child undergo CT recommended by their doctor did not significantly change. No parent refused or requested to defer CT after reading the handout.

While most parents knew that CT uses radiation, we were surprised to find that most parents did not realize that this radiation exposure is associated with an increased risk of cancer, said Dr. Larson.

While we were working on the handout, we found it extremely difficult to find meaningful estimates of exposure, dose, and risk for various types of procedures--even in the radiology literature. It is then not surprising that not only do parents underestimate the risk, but so do clinicians and radiologists, he said. When addressing the question of how much does a CT increase the risk of cancer" rather than providing a meaningful basis of comparison, most publications give one of two responses; either the risk is slight or it depends. While both may be accurate, neither are very helpful, he said.

Even though risk estimates are fraught with uncertainty, a reasonable quantitative estimate is an improvement upon slight, said Dr. Larson. If radiologists expect clinicians to have these discussions with their patients, then we need to do a better job discussing this subject amongst ourselves and with clinicians. We believe such information should be straightforward, accurate, and widely available, he said.

Contact: Necoya Lightsey
American Roentgen Ray Society

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