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Doctors: Risk of cancer low from CT scan radiation

Some patients have been worried about procedure
 Posted: 2:00 AM June 28, 2011

News that Ashland Community Hospital performed an unusually high number of double CT scans in the past has some patients worried about radiation exposure, but radiologists said two scans increase a patient's lifetime risk of dying from cancer by one-tenth of 1 percent or less.

The hospital has significantly cut its use of double CT scans.

Some patients are worried about past scans, while others are concerned because their doctors have ordered a CT scan. CT scans have higher radiation levels than regular x-rays.

But a CT scan can be an important diagnostic tool for doctors, said Rob Hibner, director of radiology at Ashland Community Hospital.

"The last thing that anyone wants is someone to delay getting care because of perceived risks," Hibner said.

The Medford Radiological Group, which aids Rogue Valley hospitals on scans and interprets results, fielded calls from worried patients after news broke last week that Ashland Community Hospital had performed double scans on 40 percent of its Medicare patients who received chest scans in 2008.

Ashland Community Hospital had the highest double-scan rate in the state, far exceeding a 6 percent double scan rate at Rogue Valley Medical Center and a 2 percent rate at Providence Medford Medical Center.

However, Ashland's hospital has since reduced its double-scan rate to about 2.5 percent of patients, Hibner said.

A double scan is when a hospital performs a CT scan with an injectable dye that helps structures like veins show up, plus a second scan without dye. Dye can obscure some problems.

Some people in the medical community thought that double scans should be used because they can help doctors make more accurate diagnoses, but the practice is now considered to be unnecessary for most patients.

Whether a person receives a single or double scan, the approximate additional risk of fatal cancer is one in 1,000 to 10,000, or significantly below 1 percent, according to a radiation information Web site developed by the American College of Radiology and the Radiological Society of North America.

Meanwhile, people already have a one in five, or 20 percent, chance of dying from cancer, the groups said.

Hibner said Ashland Community Hospital invested in a CT scanner with low dose software in 2005. Hibner said getting an accurate diagnosis and appropriate treatment that can save your life outweighs radiation risks.

Dr. Michael Troychak, a radiologist and president of Medford Radiological Group, said patients who are worried about radiation should talk to their doctors who are ordering CT scans.

He recommended asking, "What are you concerned I might have, and what can you expect to find with a CT scan?"

Troychak said he doesn't believe Ashland Community Hospital performed double scans to make more money from Medicare, since the difference in reimbursement rates for a single or double scan are negligible.

"Doctors had good intentions," he said, noting that views about double scans have changed over time.

Hibner said the Medicare reimbursement rate for a chest CT scan with dye is $301.22, while the reimbursement rate for a scan with dye plus a scan without dye is $328.48.

Troychak said CT scans are not appropriate in some cases. For example, some facilities exposed people to unnecessary radiation by offering CT scans to healthy people with no symptoms as a tool to screen for diseases.

He said he doesn't know of any facilities in the Rogue Valley that did that.

"In certain states with outpatient centers run by entrepreneurs, they had scanners that weren't busy and they were willing to take in any patient off the street," he said.

For more information about radiation from CT scans, x-rays and other types of diagnostic tests, visit www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray.

Reach staff reporter Vickie Aldous at vlaldous@yahoo.com or 541-479-8199.


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