Overexposed? Frequent scans up cancer risk

Report finds Americans exposed to seven times more radiation than in 1980

updated 4:35 p.m. ET, Tues., March. 3, 2009

CHICAGO - Americans are exposed to seven times more radiation from diagnostic
scans than in 1980, a report found on Tuesday as experts said doctors are
overusing the tests for profit and raising health risks for patients.

The findings, issued by National Council on Radiation Protection and
Measurement, add to already mounting evidence that doctors are ordering too many
diagnostic tests, driving up the cost of healthcare in the United States and
potentially harming patients.

While diagnostic scans give doctors valuable information and many times are
necessary, doctors fear too much radiation exposure can cause cancer,
especially in younger people.

"Imaging has literally become the guiding hand of medical practice," said Dr.
James Thrall, chair of the American College of Radiology's Board of
Chancellors who was not part of the study.

Financial incentive?
"Unfortunately, one of the things we have seen in the imaging world is that
many physicians look at imaging as the solution to their financial problems,"
Thrall, head of radiology at Massachusetts General Hospital in Boston, said in
a telephone interview.

He said imaging technology has created a financial incentive for some doctors
to cash in by referring patients to get imaging tests on equipment in their
own practices. This is one place the federal government and Congress can look
in enacting healthcare reform, Thrall added.

A study by the Government Accountability Office in July found Medicare
spending on medical imaging doubled to about $14 billion a year between 2000 and
2006, driven largely by increases in high-tech imaging.

In November, a 10-year study by a team at the University of California, San
Francisco, found use of computed tomography or CT scans, an advanced type of
X-ray, doubled among patients in a large managed care plan between 1997 and
2006.

Thrall said advanced diagnostic scans have revolutionized the way doctors can
treat patients, eliminating the need for unnecessary exploratory surgery and
improving patient care.

But hundreds if not thousands of non-radiologists have purchased imaging
equipment for their offices, and many studies suggest this has helped to drive up
medical costs.

The GAO report, for example, found that from 1998 to 2005, the number of
self-referred, in-office CT, MRI and nuclear medicine scans done on Medicare
patients grew at triple the rate of the same exams performed in all other settings,
such as hospitals or stand-alone imaging centers.

"There is a fundamental problem when the person ordering the study has a
direct financial interest in maximizing the use of a particular piece of
equipment," Thrall said.

He said the American College of Radiology is working with other radiology
groups to craft standards about the appropriate use of imaging, which, when used
properly can improve patient care and help cut medical costs.

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