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Radiation exposure from imaging procedures has been linked to an increased risk of various cancers, including lung and breast cancers, with infants facing a significantly heightened risk.
Recent research conducted at the University of California, San Francisco, suggests that CT scans may contribute to 5% of all cancer cases annually. The study emphasizes the importance of moderation in the use of CT technology.
The threat posed by these scans is particularly concerning for infants, followed closely by children and adolescents. However, adults also face considerable risks as they undergo the majority of these procedures.
This year alone, nearly 103,000 new cancer cases are projected to arise from the 93 million CT scans conducted in 2023, a figure that is estimated to be three to four times higher than previous calculations indicated.
Published on April 14 in JAMA Internal Medicine, this study was financed by the National Institutes of Health.
“While CT scans can be critical for saving lives, their potential risks are frequently underestimated,” warned Dr. Rebecca Smith-Bindman, the study’s lead author and a radiologist at UCSF, as well as a professor specializing in epidemiology and biostatistics.
Dr. Smith-Bindman highlighted that with the extensive use of CT imaging in the U.S., a significant number of future cancers may arise if current practices persist. She holds a position at the Philip R. Lee Institute for Health Policy Studies and leads the Radiology Outcomes Research Lab.
“Our findings suggest that the risks associated with CT scans are comparable to other known risk factors, such as heavy alcohol use and obesity,” she stated. “By minimizing the frequency of scans and the radiation doses per scan, we can improve patient safety and potentially save lives.”
Benefits and potential dangers
Computed tomography (CT) is an essential tool for tumor detection and diagnosing various medical conditions, with its usage increasing by 30% in the U.S. since 2007.
These scans, however, do expose patients to ionizing radiation—a recognized carcinogen. The associated cancer risks with CT technology have been acknowledged for some time.
To evaluate the public health ramifications of existing CT practices, Smith-Bindman’s team calculated the projected lifetime cancer cases resulting from radiation exposure related to the CT scans performed in 2023.
The study analyzed 93 million scans involving 61.5 million patients in the U.S. The prevalence of scans increased with age, reaching a peak among adults aged 60 to 69. Notably, children represented 4.2% of these examinations. In assessing risk, the researchers excluded scans performed within a patient’s final year of life, as these unlikely would lead to new cancer cases.
Future cancers from radiation exposure
The age group 50 to 59 was found to have the highest projections for new cancers, with estimates of 10,400 cases for women and 9,300 for men.
For adults, the most commonly predicted cancers included lung, colon, leukemia, bladder, and breast cancers. In pediatric populations, thyroid, lung, and breast cancers were the most frequent.
CT scans of the abdomen and pelvis accounted for the majority of projected cancers in adults, while pediatric cases primarily stemmed from scans of the head. Notably, infants who underwent CT scans were found to have a tenfold increase in cancer risk compared to older age groups.
The researchers pointed out that many CT scans are unnecessary and prescribed frequently, particularly for minor issues like upper respiratory infections or headaches lacking serious symptoms. They advocated for patients to minimize such scans and consider lower-dose options.
“The variability in the radiation doses administered during CT scans is concerning, with some patients receiving dangerously high levels,” Dr. Smith-Bindman remarked.
Dr. Malini Mahendra, a co-author and assistant professor of Pediatric Critical Care at UCSF, stressed the importance of raising awareness among families regarding the cancer risks linked to pediatric CT scans.
“Currently, many patients and their families are not adequately informed about the risks associated with CT examinations,” Dr. Mahendra stated. “We hope that our research will enhance clinicians’ abilities to communicate these risks effectively, enabling more informed decision-making about the potential benefits and dangers of CT scans.”
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