Immediate health risk must be weighed against radiation-induced cancer risk
The lifetime risks of cancer from medical radiation may be overemphasized relative to more immediate health risks, according to a new study published online in the journal Radiology.
Radiation exposure from computed tomography (CT) and other medical sources has drawn considerable media attention in recent years. Stories warning of the dangers often focus on the lifetime risk estimates of radiation-induced cancer from repeat examinations. This approach has limitations, said Pari V. Pandharipande, M.D., M.P.H., abdominal and genitourinary imaging specialist at Massachusetts General Hospital and Harvard Medical School in Boston, especially in regard to clinical decision making.
Physicians often order imaging exams to diagnose, treat or monitor life-threatening conditions. The immediate or near-term risk of death from the condition should be taken into account when weighing the benefits of an exam against a potential future risk of radiation-induced cancer from imaging.
"This must be considered when physicians make imaging decisions for their patients, because the timing of risks changes their relevance," Dr. Pandharipande said. "Risks incurred later in life are not the same as those faced in the present. If you had to choose between the chance of incurring a serious risk now or later in life, most people would choose the latter."
Dr. Pandharipande and colleagues recently used CT radiation dose data and mathematical models to better understand the risk-benefit dynamic of medical radiation. They projected outcomes for testicular cancer patients who undergo CT surveillance in the decade after orchiectomy, or removal of the testicle.
"Testicular cancer affects younger men, and patients treated for early-stage cancer receive several CT scans during surveillance," Dr. Pandharipande said. "These patients do very well, but they have a greater risk of radiation-induced cancer later in life."
Based on the results of their analysis, the researchers projected that 33-year-old men with early-stage cancer who undergo CT surveillance incur a slightly higher lifetime mortality risk from testicular cancer compared with potential radiation-induced cancers. Because the testicular cancer risk was more immediate, life expectancy loss attributable to testicular cancer was more than three times greater than life expectancy loss attributable to radiation-induced cancers.
The trends were consistent across all the scenarios studied, and put forth a useful concept to help physicians with decision making.
"Radiation-induced cancer risks, often discussed at the population level, can be challenging to conceptualize and apply to imaging decisions that have to be made at the patient level," Dr. Pandharipande said. "We as physicians can benefit from dedicated educational efforts to improve decision making and better convey the risks to patients."
Although the study focused on testicular cancer patients, concepts pertaining to the timing of radiation-induced cancer risk translate to other scenarios where CT is needed to avert a more immediate health risk, Dr. Pandharipande noted.
More information: "Patients with Testicular Cancer Undergoing CT Surveillance Demonstrate a Pitfall of Radiation-induced Cancer Risk Estimates: The Timing Paradox." Radiology, 2012.
Journal reference: Radiology
Provided by Radiological Society of North America
- CT scans increase cancer risk estimates in multiply-imaged emergency department patients May 05, 2009 | not rated yet | 0
- Cancer risk from cardiac CT overstated: researchers say Nov 10, 2008 | not rated yet | 0
- Risk of CT-induced cancer minimal compared to risk of dying from disease May 01, 2012 | not rated yet | 0
- Radiology department develops smartcard to communicate radiation risks of adult radiologic exams Apr 02, 2012 | not rated yet | 0
- CT scans: Too much of a good thing can be risky Mar 31, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer May 24, 2013 | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer May 24, 2013 | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
15 hours ago | 5 / 5 (2) | 5
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
7 hours ago | not rated yet | 1
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
15 hours ago | not rated yet | 1
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
15 hours ago | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
15 hours ago | not rated yet | 0