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Children and adolescents who undergo CT scans are slightly more likely to develop cancer than those who do not, according to a study based on Australian Medicare records for nearly 11 million people.

The study found a 24 percent increased risk of cancer over a lifetime. Putting it another way, the researchers said that in a group of 10,000 young people, 39 cancers would be expected to develop in 10 years. If all 10,000 had undergone a single CT scan, 6 extra cancers would occur.

The study, undertaken by Australian and British scientists, was published last week in BMJ.

In an accompanying editorial, Aaron Sodickson, MD, PhD, section chief of emergency radiology and medical director of CT at Brigham and Women’s Hospital in Boston, emphasized that the incidence of cancer in children is extremely small. Therefore:

A 24% increase makes this risk just slightly less small.

The study encompassed all Australians who were 19 or younger on January 1, 1985, or who were born between then and December 31, 2005. That amounted to 10,939,680 people, of whom 689,211 had at least one CT scan. Follow-up ended on December 31, 2007. The mean length of follow-up was 9.5 years for the children exposed to a CT scan and 17.3 years for those in the unexposed group.

The study notes that nearly 60 percent of the CT scans were of the brain. “Some low grade cancers in the brain may have given rise to symptoms that were investigated several years before they were finally diagnosed (that is, the brain cancer may have caused the scan, rather than vice versa),” the study cautions.

However, repeating the analysis while excluding brain cancers occurring after a CT scan changed the overall results only slightly.

The study mentions “the undoubted benefits of CT scans in clinical practice” and notes that technological advances and updated protocols since the period of the study have reduced the radiation dosage from CT scans. Still, it suggests, CT remains overused in children. It specifically cites cases of minor head trauma or suspected appendicitis.

It concludes: “All parties, including patients and families, need to work together to ensure that CT scans are limited to situations where there is a definite clinical indication, and where every scan is optimised to provide a diagnostic CT image at the lowest possible radiation dose.”

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A radiologic technologist sues a hospital, saying she was fired for requesting medical leave to care for her disabled son. For details, see our Facebook page.

Related seminar: Advances in Fetal and Neonatal Imaging (all new release)

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