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John R. Fischer, Senior Reporter | March 16, 2018
If you use a cancer risk estimate developed for relatively high doses from the Nagasaki or Hiroshima survivor population, multiply it by the radiation dose associated with a CT scan, and then multiply that by the millions of people who will get a CT scan, you will come up with a relatively large number of people who theoretically could develop cancer in 30 to 40 years. People have done that, but it is considered to be an inappropriate procedure. It’s based on the linear no-threshold model which is false.
Imaging has essentially replaced exploratory surgeries that resulted in actual, not predicted and undocumented deaths falsely assumed to result from low-dose exposures.
HCB News: What factors should providers and parents consider when the option of pediatric CT or PET/CT is being discussed?
JS: Again, they have to overcome this radiophobia. I don’t blame the patients or the parents. It gets reinforced time and time again by the media, regulators, misinformed physicians, etc.
Think about airline pilots and stewardesses. They get a pretty hefty radiation dose from natural radiation because they’re up in the cosmos all the time, where the radiation dose is higher. Yet, they’re not considered to be radiation workers like an X-ray tech, but they get, believe it or not, higher radiation doses than workers in nuclear medicine or radiology. And this dose is not regulated by anyone. There is no difference between natural radiation that is all around us and that from imaging equipment. There’s never been a study done to show that airline pilots are more susceptible to developing cancer than a plumber.
I think physicians have to act in the best interest of their patients, and if the best interest of their patient is they need to get a CT, the benefit far outweighs the only theoretical risk.
While it may seem logical to attempt to assuage the public’s fears by accommodating to their misperceptions and focusing on using the lowest dose possible, I contend that this will only reinforce their misperception. The public’s trust in medical practitioners can only be preserved if we can convince them (public and physicians alike) that there is little harm to begin with. Indeed, accurate information about low-dose radiation is the only way to undo the fears.
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