Letters to the Editor

Scans' potential harm outweighs the benefits

Shocking. How else to characterize Dr. Paul Long's letter recommending total body CT scanning every 18 months in asymptomatic, unselected adults as appropriate screening for cancers?

Claiming costs of "about $50 a month," he ignores the intolerable cost of increasing cancer incidence because of greater radiation exposure.

X-rays cause chromosomal and cellular damage. All experts agree that lifetime exposure, which is cumulative, must be minimized.

Total body scans deliver more than 100 times the radiation dose of a chest X-ray. Usually, two to three scans are required each time. Radiation experts estimate doing 30 annual such scans in 100 45-year-old men will cause about five test-related additional cancer deaths, assuming that the scanners are accurately calibrated to deliver minimally necessary radiation.

Lung CT screening in patients predisposed to cancer (heavy smokers) may result in small reductions of cancer death rates, but the exposure is limited to the lungs.

The American College of Radiology, whose members have a financial interest in doing scans, recommends that total body scans not be done routinely because the harm (financial and health) is greater than any benefit. The National Cancer Institute and the American Cancer Society concur.

The letter makes one wonder whether the motivation is just to do good. Professional ethics should require anyone making such recommendations to state any financial interest in ordering and performing these scans.

Anyone contemplating undergoing total body scans, as advocated, should be aware of the serious hazards and limited benefits and should seek other professional advice before deciding.

Dr. Karl Engelman

Hilton Head Island

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