Forecast: 103,000 new cancer cases each year because of one increasingly popular test?
Key Takeaways
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"Not saying CTs are bad—they save lives when used appropriately. But when we order them out of habit, anxiety, or convenience, we expose patients to risks that aren’t always necessary." — Joe Whittington, MD, ER doctor
For so many patients, a CT scan seems like the obvious next step. But here’s the thing: Just because it’s routine, doesn’t mean it’s harmless.
“When we order [CT scans] out of habit, anxiety, or convenience, we expose patients to risks that aren’t always necessary. Bottom line: Just because it’s common doesn’t mean it’s harmless. Ask if the scan will actually change your treatment. If not, maybe it can wait,” said ER doctor Joe Whittington, MD, in an Instagram Reel.
This message is more important than ever, because the rates of CT scans themselves have skyrocketed—up by more than 30% since 2007.
In fact, it's estimated that 1/3 or more of all scans are not necessary—and they may be the cause of 5% of new cancers each year, according to researchers publishing in JAMA. They also estimated that CT scans conducted throughout the year of 2023 would result in approximately 103,000 new cancer cases.[]
What's driving the trend of unnecessary scans?
It's no secret doctors don't have a ton of free time on their hands, so ordering a CT scan is often the better option over sitting down with a patient to figure out the root cause of a health issue, according to the study's lead author Rebecca Smith-Bindman, MD, per an interview with The Cut. []
"It would also be disingenuous to not acknowledge that medical imaging is a very profitable part of the healthcare system, and one of the drivers of scanning is that it brings in revenue," Dr. Smith-Bindman said. []
Not to mention, sometimes the patient is the one who wants the scan to ease their anxiety about a medical issue they're having.
"Even if the clinician has informed them that the likelihood of finding an actionable finding is extremely low, they still might want to get the CT scan because they want to be sure that their headache doesn’t reflect a brain cancer," Dr. Smith-Bindman said. []
Related: Are you ordering the wrong imaging for your patients?Are CT scans causing cancer?
While the immediate convenience of these scans might be clear, the long-term risks can be harder to see—until they’re not.
A recent study published in JAMA Internal Medicine put a sobering number on this: CT scans could be responsible for up to 5% of new cancer cases each year. [] Let that sink in: One in 20 new cancer cases could be linked to diagnostic radiation.
One of the biggest challenges? There are no standardized doses for CT radiation. [] The amount of exposure a patient receives can vary widely depending on the protocol and machine used.
So while doctors may try to limit exposure, the lack of uniformity can inadvertently put patients at risk.
What this means for clinicians
Think twice: Will this scan change your treatment plan? If not, maybe it can wait.
Talk with patients: Dig deeper into their medical history and concerns before ordering a scan. If they ask for one, chat with them about other possible diagnostic options.
Advocate for dose reduction: Where possible, push for standardization and lower-dose protocols.