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Two studies published in the 2009 December issue of the Archives of Internal Medicine suggest that CT scans deliver far more radiation than previously believed and may contribute to 29,000 new cancers each year, along with 14,500 deaths. A study led by the National Cancer Institute's Amy Berrington de Gonzalez used existing exposure data to estimate how many cancers might be caused by CT scans.
One study found that people may be exposed to up to four times as much radiation as estimated by earlier studies. While previous studies relied on dummies equipped with sensors, authors of the new paper studied more than 1,000 patients at four hospitals.
Based on their measurements, a patient could get as much radiation from one CT scan as 74 mammograms or 442 chest X-rays.
Young people are at highest risk from excess radiation, partly because they have many years ahead of them in which cancers could develop. Among 20-year-old women who get one coronary angiogram, a CT scan of the heart, one in 150 will develop cancer related to the procedure.
In a separate study, Dr. Rebecca Smith-Bindman of the University of California, San Francisco, and colleagues analyzed data from 1,119 patients undergoing the 11 most common types of diagnostic CT scans at four institutions in 2008. According to her, up to one-third of all CT scans are unnecessary. Doctors sometimes order CT scans for convenience because they don't have access to results at another facility, says Rosaleen Parsons - chair of diagnostic imaging at Philadelphia's Fox-Chase Cancer Center. She suggests that patients keep their medical records and ask doctors about alternatives that don't involve radiation exposure. Patients also should ask if a facility has been accredited by the American College of Radiology, she says.
Making matters worse is the fact that the use of CT scans in medicine has grown explosively -- more than tripling in the US since the 1990s, with more than 70 million given each year.
Additionally, dyes injected for contrast during radiographic procedures, such as angiography and CT scans, may injure kidneys that are weakened by disease. When arranging these tests, advise your doctor of your kidney problems.
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