Many doctors and certainly their patients have "little knowledge" of the cancer risk posed by having a CT scan, radiologists say, amid concerns over their overuse in Australia.
About one in every thousand children who undergo a CT (computed tomography) scan will go on to develop cancer triggered by radiation used in the procedure, the NSW-based radiologists say.
The cells of children and young adults were at heightened risk of a harmful mutation because they were dividing more rapidly at the time of the scan.
John and Margaret de Campo, radiologists at Tweed Hospital, said the risks were well documented in scientific literature but this information had not filtered into the broader community.
"Surveys of both patients and referring doctors show they have limited knowledge of the radiation risks from CT," the radiologists write in an article published by the Medical Journal of Australia.
"Hence most patients presenting for CT scans are not informed or aware of the risk."
They said the risk of a CT scan-triggered "fatal malignancy" developing later in life was one in 500 for children under the age of one, one in 1,250 for children up to ten years and one in 1,600 for those up to 20.
The risk of dying as a result of a CT scan was up to 200 times higher than the risk of death as a result of having a general anaesthetic, they write.
Yet, they write, it was not routine to ask a patient to provide written consent indicating they were aware of these risks ahead of undergoing their CT scan.
"If informed consent is regularly sought before administration of general anaesthesia ... then it is equally appropriate and consistent to seek informed consent before CT scans in children and young adults," the radiologists said.
"Anything less may not be medico-legally sustainable."
The radiologists point to a High Court of Australia ruling which determined that medical staff must inform patients of the potential risks that the patient might regard as important.
The said the doctors who refer these patients to have a CT scan should seek written consent, and also provide their patients with written information detailing the risks of the procedure.
The comments come after the nation's health profession watchdog on Monday warned that doctors were ordering CT scans at higher rates than in other western countries.
"I have been alarmed at the number of these scans ordered without clinical justification," Professional Services Review (PSR) director Dr Tony Webber states in the watchdog's latest report.
"Practitioners should always consider the risks of radiation exposure particularly in younger patients."
The PSR report cites one case where a doctor ordered a scan for a patient who had experienced back pain for less than 24 hours.
The Royal Australian and New Zealand College of Radiologists (RANZCR), the peak body for radiologists, said doctor training and a lack of government funding for alternative MRI scans were key drivers of the overuse of CT scans.
Magnetic resonance imaging (MRI) scans don't carry the same cancer risk and, in many cases, they produced more relevant scan results.
"The problem with inappropriate use of CT scans is as much related to government policy as it is to inappropriate referrals," said RANZCR president Dr Matthew Andrews.
"Blaming doctors and particularly GPs for requesting unnecessary or inappropriate tests is unhelpful."
Front page
Health home
RSS Feed