excessive use of CT scans

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Lawyers looking at excessive use of CT scans

 

The rapidly increasing use of CT scans, and the consequent cancer risks,

threaten to become a public health issue of the future, experts warn. Large

increases in CT use is predicted to continue over the next few years, with

already up to one third of scans in the US not medically justified, say the

authors of a NEJM review.

A large part of the projected increase for adults will come from new CT-based

screening for asymptomatic patients, such as virtual colonoscopy and CT cardiac

screening, they say.

And diagnostically, there is considerable literature questioning the use of CT

for blunt trauma, chronic headache and seizures, and suspected appendicitis in

children.

“The growth of CT use in children has been driven by the decrease in the time

needed to perform a scan – now less than 1 second – largely eliminating the need

for anaesthesia”, say the authors.

“Clinicians often view CT scans in the same light as other radiological

procedures, even though radiation doses are typically much higher with CT than

other radiological procedures”.

However, medico-legal expert Mr Bill Madden says that while both referring

doctors and radiologists have a responsibility to inform patients of the risks

of CT scans, an extensive warning would not usually be necessary.

Mr Madden, National Practice Group Leader of medical negligence from Slater

and Gordon, says concerns that individual practitioners may be subject to

litigation for ordering CT scans for individual patients are also probably

unfounded.

Our legal system does not cope well with this sort of statistical increases in

risk, he told 6minutes.

 

“It would be very difficult to prove that a particular cancer was caused by

repeated exposure to CT scan”, he says.

The NEJM authors say new generation scanners go some way to reducing overall

radiation dose from CT to the population. As well, clinicians should use other

imaging such as ultrasound where possible, and ensure that all scans ordered are

necessary.

 

30 November 2007

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