Concerned that Americans may be accumulating too much lifetime radiation exposure from medical tests, doctors at the National Institutes of Health will begin recording how much radiation patients receive from CT scans and other procedures in their electronic medical records.
A study in the Archives of Internal Medicine in December estimated that radiation from such procedures, whose use has grown dramatically in recent years, causes 29,000 new cancers and 14,500 deaths a year.
A second Archives study that month said the problem could be even worse, calculating that patients get four times as much radiation from imaging tests as previously believed. Children are particularly vulnerable because they're small and still growing.
These exposures do not include the rare cases of machine malfunctions or mistakes, such as the disclosure by Cedars-Sinai Medical Center in Los Angeles in October that it had accidentally given hundreds of patients up to eight times the normal radiation dose during a stroke scan.
Even though most machines function properly, hospitals rarely record how much radiation patients receive. Doses can vary, depending on the size of the patient, how large of an area is scanned or the number of scans performed. At NIH, doctors now will routinely record such information in records that patients can take with them, according to an announcement today in the Journal of the American College of Radiology.
If other hospitals follow NIH's lead, this information will enable researchers eventually to compare the cancer risk of patients with high vs. low radiation exposures, authors David Bluemke and Ronald Neumann of NIH say in their paper.
The NIH by itself doesn't treat enough patients to measure such risks, which would require data from hundreds of thousands of patients, they write. But they hope to eventually pool data from many institutions to measure cancer risk.
Rebecca Smith-Bindman, who wrote one of the December studies in Archives, praises NIH for the change. "It is an absolutely necessary first step toward monitoring patient dose," Smith-Bindman says. "I suspect in the not-so-distant future this will be required of all institutions."
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