CT Scans and Children–Consider the Risk/ Benefit Ratio

A new pediatric imaging study has been making headlines, but it’s important for patients to keep in mind both the risks and benefits of CT scans when evaluating the research. The study, published this week in Lancet, a British medical journal, claims that CT scans expose children to cancer causing radiation.

According to the researchers, for every 10,000 CT scans performed on children under the age of 10, one additional child will get a brain tumor and another child will get leukemia within 10 years of the initial scan. The research claims that these cancers would not have otherwise been expected regardless of medical imaging exams.

However, this article documents an extremely small risk. In fact, this figure is less than what we have been assuming historically prior to any evidence. But, the article also cautions that any decision on whether or not to scan should involve a risk/ benefit ratio consideration. The study does not change our assessment of risk in that ratio. Thus, the potential benefit from CT remains the critical determinant on whether to perform a scan.

As always, the ACR appropriateness guidelines help with that assessment. That also is the role of trained Board Certified radiologists—to know and advise about when CT scanning creates a risk/ benefit ratio strongly in a patient’s favor.

Remember parents, discussing the risks of CT with your health care provider should certainly be done, but be sure to get the full set of facts before refusing care that may save and extend a child’s life.

Further Validation: American Lung Association Supports CT Screening!

Another major organization has joined the U.S. National Cancer Institute to support CT lung cancer screening as a life saving procedure! Recently, the American Lung Association updated its recommendations to support low-dose CT lung screening for smokers and former smokers.

Lung cancer continues to be the leading cause of death in the U.S., with more than 150,000 deaths annually and a five year survival rate as low as 15 percent. However, research from the US National Cancer Institute’s Lung Cancer Screening Trial gives promising hope. The study found that low-dose CT can reduce mortality rates by at least 20 percent among smokers and former smokers. Other published reports have estimated even higher rates of mortality gains! According to the LCST, individuals between the ages of 55 and 74 years who are current or former smokers of at least 30 pack-years and have no history of lung cancer are ideal candidates for lung cancer screening with CT.

Currently, besides never smoking, low-dose CT screening is the only viable option for significantly reducing the risk of lung cancer. The ALA’s recommendation of this medical imaging exam is an important step toward the development of widespread population-based CT screening program through the U.S.

The ALA joins the National Comprehensive Cancer Network, the first major professional organization to recommend low-dose lung cancer screening last fall.

For more information on factors that may effect the widespread implementation of lung cancer screening, see this post on low-cost screening.