Big elephant in the room: Pre-test ban atmospheric nuclear tests. Of course, there's nothing anyone can do about it. The somatic damage period is probably more or less over, but we are transitioning through the genetic damage period.
If this was a big elephant in the room, then I would expect there to be some modicum of evidence that this causes any increase in cancer risk. Maybe a shred of evidence that cancer rates have gone up? Anything. We'll wait.
We Are Giving Ourselves Cancer
71–80 of 167 posts
Re: We Are Giving Ourselves Cancer
#72I have no doubt that patients are getting exposed to more radiation via imaging than they need to. However, every decision in medicine is (or should be) a risk-vs-benefit analysis. Cancer is not the only thing you can die from. If you suffer a head injury and end up in the ER and get a CT scan, you may increase your long-term risk of cancer, but you are also drastically reducing the risk of dying from a brain hemorrh…
The doctors are doing a risk/benefit analysis: the risk is to the patient and the benefit is to their wallets. It's a no brainer. Everyone likes to shit on lawyers, but US doctors routinely take on, and fail to disclose, conflicts of interest that would get a lawyer disbarred in a heartbeat.
Re: We Are Giving Ourselves Cancer
#73Personally, I don't care about regular x-rays, particularly digital ones, for any reasonable medical use. I get one every year or two as part of a checkup.
CT and C-arm fluoroscopy scare me, as an educated person who isn't a doctor but knows more than 99% of people about radiation safety, and I'd want there to be a clear clinical need and decision supported by them. Which is the standard I saw applied. (I never actually saw a c-arm procedure) In extreme trauma you might err on the side of a CT in 1/100 cases. but that's not a big deal.
Re: We Are Giving Ourselves Cancer
#74Personally, I like to think of medical imaging in terms of how long I'd have to work as a flight-attendant to get the same dose. When you fly at high altitudes (as most passenger jets do) there is less atmosphere to block cosmic radiation, which is the source of background radiation that we're exposed to every day. You get a higher dose of radiation at high altitudes amounting to a few tens of microsievert's for a decently long flight. Medical X-Rays that consist of a single photo are approximately in the same ball-park as an intercontinental flight or two, or working as a flight-attendant for a day or so. CT scans are in the ballpark of several months working as a flight-attendant. It sounds bad at first, but flight-attendants aren't known to have a massively increased rate of cancer after doing the job for decades.
In general, people fear radiation to an extent that is out of proportion with reality. To add more perspective, the background radiation in your living room will add up to a CT scan, most likely, in less than a year (unless you live in very deep mine). You can marginally improve your odds of getting cancer by avoiding medical scans, but only at the cost of massively increasing your odds of dying from something those scans might have helped diagnose. It's not an intelligent trade-off. Yes, unnecessary CT scans are bad, but not as bad as the article claims. The greatest cost of an unnecessary CT scan is probably to those who don't get scanned due to high demand on the machine. This article, by stoking irrational fears of medical imaging, is more likely to harm people than help them.
Note: Medical imaging is generally not done very often, is tracked, and is usually performed by trained technicians with quality apparatus. The same is not true of security X-Ray scans, which people can be subjected to much more frequently, are frequently performed by the near-unemployable, and use machines that are not designed with the primary goal of helping those it scans. The U.S. is also starting to use truck-based scanners to scan parked vehicles and people on public streets. You may be scanned by these not only without consent, but without knowledge. I do find this to be objectionable.
Re: We Are Giving Ourselves Cancer
#75Let's simplify this. Industrial waste is everywhere. Old buildings are built with cancerous materials and we are expose to all kinds of radiations and air pollutions. We eat junk food, we don't exercise much. Kids are playing with toys painted with lethal chemical substances. Second-hand smoking is always present. We eat overfried food and we also sleep late. So the story is clear and doesn't require some heavy scien…
Sleeping late caused cancer now???
http://www.huffingtonpost.com/2013/08/27/stress-cancer-gene-...
If you think cancer is all about radiation, you are wrong..
Re: We Are Giving Ourselves Cancer
#76Earlier quoted context omitted.
The Wikipedia article lists a full body CT scan at 10-30 mSv.
I was going off the list http://en.m.wikipedia.org/wiki/X-ray_computed_tomography and in haste I stopped after head and chest. You are right, I should have gone further down to the full-body as well. Thanks for that. Incidentally, this is exactly why I included the numbers - so you can check them, and why I don't like the headline article - no numbers and no references, so there is nothing to check, only vaguely scar…
It's been huge in dental x-rays, going from film to CR/DR (although dental isn't huge, it's routine, and involves a large patient population including kids.)
We probably will be Fluoroscopy on the other hand is easily 50 mSv/min and multi-hour procedures (!!!). People get acute effects from that.
Re: We Are Giving Ourselves Cancer
#77Earlier quoted context omitted.
>If you do the math by ICRP formulae, you end up with increase chance of cancer of 1 in 2600 over the next 20 years from a single 7ms CT scan today. This compares favorably with "natural" risk that is 1 in 10 without any extra exposure above background radiation. But that is a meaningless comparison. The doctor should be comparing this additional risk, to the benefit of the scan. The "natural" risk of developing canc…
Because we operate in likelihood ratios, the unexposed risk is important so the risk can be computed (at least, in theory; in practice, people go more by indication than by formal risk prob/benefit prob).
If I want to know whether to do a CT scan, the only relevant fact is the increase in probability (in an absolute sense) of cancer that it causes.
It seems like either you, or the entire field of medicine, is obfuscating this basic fact using some field-specific concepts.
EDIT: It seems like you are referring to relative risk (http://en.wikipedia.org/wiki/Relative_risk). But as I said, there is no reason that relative risk should be considered in this case.
Re: We Are Giving Ourselves Cancer
#78CT Scan doses vary wildly depending on the type of X-ray (chest, head, limb, etc.), the size of the person, and a lot of other things. The bigger the cross-section of the thing you put in a scanner, the greater the exposure. CT machines themselves also vary considerably. Newer machines are often more sensitive and employ better imaging software, so they can do their job while delivering a much smaller dose. Anyone wh…
Re: We Are Giving Ourselves Cancer
#79Earlier quoted context omitted.
>If you do the math by ICRP formulae, you end up with increase chance of cancer of 1 in 2600 over the next 20 years from a single 7ms CT scan today. This compares favorably with "natural" risk that is 1 in 10 without any extra exposure above background radiation. But that is a meaningless comparison. The doctor should be comparing this additional risk, to the benefit of the scan. The "natural" risk of developing canc…
I see your point. I wonder though if there should be a cutoff somewhere, below which you stop caring? I used background cancer rates as an anchor to judge if the cutoff has been reached, without getting specific about benefits of treatment in each particular case. Would you suggest another cutoff level that is broadly applicable?
So if you are certain that the benefit of the scan is, no matter what the particular case, going to be worth much more than a 1/1000 chance of getting cancer, then that is a reason to ignore the risk.
Re: We Are Giving Ourselves Cancer
#80When I worked with radiologists (at a PACS vendor, mainly selling to the military and the federal prisons), the radiologists and staff were exercising due care about minimizing radiation exposure from CTs. Personally, I don't care about regular x-rays, particularly digital ones, for any reasonable medical use. I get one every year or two as part of a checkup. CT and C-arm fluoroscopy scare me, as an educated person w…