[Intl_DxMedPhys] New JAMA IM article on CT radiation dose and future cancers

[Mark Supanich]

There's a new article in JAMA internal medicine out predicting a large number of future cancers from CT scans. https://urldefense.com/v3/__https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832778__;!!KGKeukY!3QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHDAyPO8c$ 
 The work is entirely statistical in nature, there is no cohort study or causal link found, just multiplying the presumed very small individual risk of each CT scan times the tens of millions scans done each year. Please read the article and be prepared to discuss it with colleagues, patients, and physicians. A few key points to remember are:
1. When ordered for medically indicated reasons the benefits of CT far outweigh any future risk
2. CT catches cancer earlier, changes and informs diagnosis, and can help patients avoid unnecessary surgeries
3. Research into radiation risk from low levels of ionizing radiation is still a field of research and consensus on what the risk is has not been reached
4. Many CT scans are performed in the last years of patient's lives and those CT scans can't contribute to future cancers (as the latency period for most solid cancers is at least 4 years). The authors only excluded scans that would have been performed in the last year of life from this paper. A more realistic exclusion of 4 or 5 years would significantly reduce the number of theoretical cancer inductions they claim.

If you want to point folks to a reasonably balanced write up - I suggest this one from Gizmodo (https://urldefense.com/v3/__https://gizmodo.com/common-ct-scans-are-major-cancer-risk-study-claims-2000588963__;!!KGKeukY!3QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHBbVsiPc$ ). The author reached out for outside comment in advance of publication, and I am grateful that he did, as I was able to (with help from Cynthia McCollough and Rebecca Milman) provide some additional context and critiques.




--

Mark P. Supanich, Ph.D., DABR, FAAPM (he/him)

Director – Diagnostic Medical Physics

Rush University System for Health

Associate Professor & Vice Chair for Physics and Informatics

Rush Medical College Department of Diagnostic Radiology and Nuclear Medicine

O: 312.563.4552

Book time with Mark Supanich<https://urldefense.com/v3/__https://outlook.office.com/bookwithme/user/359cac7eb98843cab54ba1332197fc80@rush.edu?anonymous&ep=pcard__;!!KGKeukY!3QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHDsvvcb4$ >

[RUSH]

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