[ RadSafe ] CT scans and cancer

[Brennan, Mike (DOH)]

Did he speculate on how many of the people who might develop cancers
could have avoided that fate by dieing of something that could have been
prevented with the help of the information a CT could have provided? 

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Brunkow, Ward
Sent: Thursday, November 29, 2007 6:19 AM
To: Steven Dapra; radsafe at radlab.nl
Subject: RE: [ RadSafe ] CT scans and cancer

Our highly discussed issue here finally made the cable TV circuit this
morning with Dr. Sanjae Gupka (? Spelling), CNN Medical Expert. He
stated that CTs were suspected in 1-3% excess cancers. 

W. G. (Ward) Brunkow





-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Steven Dapra
Sent: Wednesday, November 28, 2007 8:00 PM
To: radsafe at radlab.nl
Subject: [ RadSafe ] CT scans and cancer

Nov. 28, 2007

         According to an Associated Press report, the authors of a
"Current Concepts" review article on CT scans in the New England Journal
of Medicine believe that "In a few decades, as many as 2 percent of all
cancers in the United States might be due to radiation from CT scans
given now."  (The direct quote is from the AP article, not from the
review article.  I found out that this is a Current Concepts review
article by clicking on this link at the end of the AP article
<http://content.nejm.org/>.  It takes you to the NEJOM website.)

         The link to the AP article (on Yahoo) is
<http://news.yahoo.com/s/ap/20071129/ap_on_he_me/dangerous_scans>.

Title of the review article is "Computed Tomography  An Increasing
Source of Radiation Exposure," by David J. Brenner, Ph.D., D.Sc., and
Eric J. 
Hall, D.Phil., D.Sc., from the Center for Radiological Research,
Columbia University Medical Center, New York.  It was published in the
New England Journal of Medicine.  The citation is Volume 357:2277-2284,
November 29,

2007; Number 22.

         You can go to this link <http://content.nejm.org/> and click in

the germane places and buy a copy on line for $10.00.  (There is no
charge for subscribers.)

         Below are some quotes from the AP article.

The risk from a single CT, or computed tomography, scan to an individual
is small. But "we are very concerned about the built-up public health
risk over a long period of time," said Eric J. Hall, who wrote the
report with fellow Columbia University medical physicist David J.
Brenner.

It was published in Thursday's New England Journal of Medicine and paid
for by federal grants.

CT scans became popular because they offer a quick, relatively cheap and

painless way to get 3D pictures so detailed they give an almost surgical

view into the body. Doctors use them to evaluate trauma, belly pain,
seizures, chronic headaches, kidney stones and other woes, especially in

busy emergency rooms. In kids, they are used to diagnose or rule out
appendicitis.

But they put out a lot of radiation. A CT scan of the chest involves 10
to
15 millisieverts (a measure of dose) versus 0.01 to 0.15 for a regular
chest X-ray, 3 for a mammogram and a mere 0.005 for a dental X-ray.

[According to] Dr. Alan Brody, a radiologist at Cincinnati Children's
Hospital Medical Center, three out of 10 parents in one study insisted
on CT scans instead of observing the child's condition for awhile even
after they were told of the radiation risk.  (Note:  The AP article does
not present Brody's comment as a direct quote.  I re-arranged the AP
article a little to make this quote.  It is an accurate representation
of what Brody seems to have been paraphrased as saying.)

         A few of my own comments:

         Why are CT scans being used to diagnose appendicitis in
children?  Why not do white blood cell counts; and do what is called
"letting up" on the patient's abdomen?  (Those who have been "let up" on

will know what I mean.)

         I think the description of exposure levels is confusing.

         What is with the 30 percent of pushy parents who want the scans

done anyway?

Steven Dapra
sjd at swcp.com



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