The authors of last week’s study about unnecessary CT scans predicted that “in a few decades, 1.5 to 2 percent of all cancers in the United States may be due to the radiation from CT scans being done now.” The fancy, expensive, lifesaving test is overprescribed and will do collateral damage.
I may be in the 1.5 to 2 percent. My doctor prescribed a CT scan to check for calcification in my arteries, which is a marker for heart disease. Result: zero calcification.
I was confident this meant I wouldn’t have to go on a statin to lower my high cholesterol. But no: Turns out the CT scan was really just a hunt for other risk factors. Zero was good, but it did not take the statins off the table. Yet I had agreed to fork over the $450 for the scan only because of my statin reluctance.
Problem is, neither of us had discussed what the end game was.
I mentioned the scan to a world-famous heart specialist at dinner, seeking reassurance about my zero score. “You’ve just increased your risk of cancer,” he said.
Point is, talk this stuff through clearly with your doctor. You can skip tests—and risks and money—if you agree on the end game.
Comments (5)
It’s not just that the assessment may have some long term effects. One additional risk with using CT scans for “screening” is that it may lead to unnecessary follow-up diagnostic or treatment procedures (for example, biopsies). All these procedures have a real risk of complications including death associated with them.
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More than half of the time, the first sign of coronary artery disease is a heart attack or sudden death. Statins have been shown to slow, stop, and (in some cases) reverse the atherosclerotic process. Better than any other test, cardiac CT scans identify who is at risk and who is most likely to benefit from treatment. At experienced centers with the latest equipment, the radiation dose from a CT scan of the heart can be very low (less than one-third the dose of a nuclear stress test). I believe when the research studies are completed, they will show that for many patients the benefits of having a cardiac CT scan will far outweigh the risks.
Gee, sudden death from coronary heart disease, or a long slow tortured death from iatrogenic produced cancer. Which would you rather take a chance on, Doc? Maybe since hospitals and slow tortured deaths are familiar to you, you’d rather take the extra X-ray-induced cancer. But please allow me to have my choice — especially since neither outcome is written in stone.
I’m cancelling my appo for that radiation test ! when I read that it was equivalent to 600 chest x-rays that gave me the creeps !!!
It’s an interesting conundrum. I recently had a cardiac CT scan as part of a volunteer project at the NIH. I am healthy. The scan showed 2 areas of plaque and otherwise normal. What I can’t seem to find out is how much plaque is normal for a 53 yr old. I am glad I did the study, I will be seeing that plaque when I make food choices: salmon or burger? extra broccoli or more fries? My cholesterol, triglycerides, are all superb, so it was a surprise.