Financial Incentives: Radiation Exposure ‘Soaring’ As Medical Imaging Tests Overused
By Chris Geo on Jun 16, 2012 with Comments
Anthony Gucciardi
NaturalSociety
Just after it was released that CT scan radiation actually triples the risk of brain tumor development in children, new research is now ousting the fact that average radiation exposure from such medical imaging tests has skyrocketed over the past decade. And the result of this admittedly ‘excessive radiation’ is an increased risk of not only cancer, but other significant health conditions.
The University of California, San Francisco (UCSF) published the findings of the study in the Journal of the American Medical Association (JAMA), which reveals just how serious the issue of radiation exposure is. Researchers write not only how the rates in which patients are scanned by the radiation-emitting machines are much higher, but there is also some concern over how many patients receive repeat scanning — ultimately leading to higher and higher doses of radiation. For those suffering from chronic issues that need consistent ‘monitoring’ from such devices, this could mean heavy radiation levels on a highly routine basis.
High radiation that is undoubtedly spiking cancer rates, as doctors are openly admitting – the same radiation that has been coming from Fukushima in amounts far exceeding original estimations and causing an ‘unknown’ number of cancer deaths. Dr. Rebecca Smith-Bindman, a professor of radiology and biomedical imaging at UCSF, explains just how dangerous radiation exposure is when it comes to the development of cancer:
“The studies are pretty clear – high exposure to radiation causes cancer.”
Such is the case even for the common dental x-ray – the seemingly harmless imaging technique that is actually associated with a two-fold or higher increased risk of developing brain cancer. This particular research was very effective in measuring the true severity of repeat scans. While patients who received the bitewing x-rays (showing upper and lower back teeth) less than once per year were only 1.1 to 1.6 times more likely to develop brain cancer, more frequent runs proved to come with a hefty price. Those receiving frequent panorex dental x-rays (an x-ray showing all of the teeth) upped their risk by 2.7 or 3.0 times — much greater than those receiving bitewing tests less frequently. What’s more, the risk increased to 4.9 times if the patient was below the age of 10.
So why the increase in medical imaging tests? The study boldly set out to examine the incentives for the spike, even examining financial factors that could play a role. Even more boldly, they reached the conclusion that financial interests were indeed one main driving factor. A sad truth considering the fact that these financial incentives are contributing to the epidemic of cancer — particularly among young children. Smith-Bindman reports:
“One of the thoughts for the change in the rise of imaging is a change in the incentives… It suggests that financial factors may play a role, but there are other factors as well.”
Locally, precautions taken to reduce radiation risk
Although modern imaging techniques have revolutionized doctors’ ability to diagnose and follow diseases, they are not without risk — including financial risks of the increasing coinsurances that many patients are forced to pay.
“This is why it is so important for patients to work closely with their physicians in taking advantage of medical history-taking and comprehensive physical examinations,” said Daniel Kantor, secretary of the Duval County Medical Society and president of the Florida Society of Neurology. He also is the medical director of Neurologique, an organization dedicated to patient-centered care, research and education.
CT scans involve a relatively high dose of radiation and, although less expensive than MRIs, do carry potential long-term health risks. MRI scans do not involve radiation and offer just as good, if not better, images than CT scans, Kantor said. CT scanning is most useful when looking for abnormalities in the bone.
Physicians are not required to inform patients in writing about the radiation risks of CTs.
Wolfson Children’s Hospital and Mayo Clinc emphasized their staffs use the lowest dosage of radiation possible in all medical imaging tests performed at their hospitals. The hospitals also adhere to rigorous standards and guidelines for those procedures.
“We do provide patients with educational materials that discuss the risks and benefits of different radiation procedures,” Mayo spokesman Layne Smith said.
Suzanne Scott, manager of pediatric imaging at Wolfson Children’s Hospital, said it has no formal policy about informing patients in writing about radiation risks.
“It’s generally up to the ordering physician to inform the patients,” Scott said.
Since February 2010, Wolfson has used special software on its CT scanner to help lower the radiation dosage up to 30 percent, Scott said. The software is in addition to other precautionary measures the radiologists and technologists already employ to ensure the lowest dose it used on patients.
Patients’ radiation levels boosted by increased medical scans
(CBS News) The number of CT scans and other medical imaging procedures are increasing at a rate that has researchers concerned about increased exposure to radiation.
Multiple CT scans in kids triples cancer risk, but researchers caution overall risk low
According to a new study published in The Journal of the American Medical Association on June 13, between 1996 and 2010, the number of CT scans tripled.
“The doses are not at a level that people should really be concerned,” Dr. Rebecca Smith-Bindman, the study’s lead author and a radiologist and epidemiologist at the University of California, San Francisco, told the New York Times. “It’s rather that we need to minimize unnecessary exposures wherever possible.”
Scientists were particularly concerned about the ionizing radiation that patients were being exposed to. Of the 1467 imaging codes, 1068 were associated with the delivery of ionizing radiation, including angiography/fluoroscopy, CT, nuclear medicine, and radiography. Ultrasounds and MRIs do not use ionizing radiation and were not included.
Radiation has been known to increase a person’s risk of getting cancer, according to the study’s authors. Some research shows that 2 percent of all future cancers will be caused by current imaging use. Another recent report in The Lancet showed a direct association between CT exposure in children and cancer risk. Children who get five to 10 scans triple their risk of developing leukemia, HealthPop reported.
The study looked at millions of health records of patients within the HMO Research Network, a group of 19 HMOs across the United States and in Israel. The specific records they looked at belonged to patients in several western and Midwestern states.
Researchers found that the amount of radiation in patients had doubled over the last two decades, as well as the number of medical imaging procedures. In 2010, 20 CTs were performed for every 100 patients. Three percent of patients overall, and four percent who underwent imaging, received radiation above the limit that the U.S. Nuclear Regulatory Commission sets for people who work at nuclear power plants and double what European regulators recommend.
For those in the 65 to 75 age group, the number increased to 35 CTs per 100 patients. Ten to 20 percent of children who had a single head CT had radiation doses known to triple the risk of brain cancer or leukemia.
The bigger problem is that a lot of these patients are exposed to multiple tests, which is significantly increasing their radiation levels, Smith-Bindman said.
“It’s not just that we’re doing more advanced imaging tests, but we are also doing these tests in such a way that the tests deliver higher – and more variable – doses of radiation,” Smith-Bindman said in the press release. “I am concerned that physicians have lowered their threshold for advanced imaging so much that it is now used even when they may not believe it is necessary or will really change their management of the patient.”
At “fee-for-service” hospitals and clinics, these procedures often provide a monetary benefit. But, the study revealed that medical imaging is increasing even for patients under health maintenance organizations (HMOs), which do not derive any financial benefits from doing the costly procedures.
“You would have imagined that the rate of increase would be lower,” Smith-Bindman explained in the press release. “Our results showed very similar growth in imaging within these integrated settings as has been shown outside of these settings.”
Smith-Bindman and her team said patients need to be more aware and “insist of the necessity and safety of all radiological scans .” The researchers encouraged patients to talk to their doctors to see if these procedures are justified, and added that facilities should monitor when patents are receiving repeated scans or more radiation doses than necessary.
Correction: This article originally suggested that MRIs were responsible for raised exposure to radiation. While the rate of MRIs has increased, MRIs do not use “ionizing radiation” and therefore were not included in the study’s results.
Filed Under: HEALTH/EUGENICS
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