Mustafa Bashir, a radiology specialist with Duke University Health System, recently shared his expertise on the growing fear of cancer due to computed tomography (CT) scans. We’re grateful for his insights to help inform this key topic. He went on to call the anticipated cancer risk from these scans “unrealistically high.” He encouraged both consumers and providers to view healthcare more holistically—particularly with respect to serious, even fatal, diseases.
Previously, CT scan usage had exploded, with an estimated 61.5 million procedures taken in just 2023 alone. In a positive sign, research is already well underway to understand the effects of radiation exposure. A recent study found an alarming link. It estimated that as much as 5% of all new cancer cases may be attributable to radiation from CT scans. Bashir made clear the dire need to understand these numbers. He noted that medical progress has greatly reduced the radiation dose in recent years.
Bashir’s main argument has to do with the methodology used in many studies estimating cancer risk. He makes the point that using such data from A-bomb survivors biases the exploration of risk of today’s advanced CT technology. “Assuming that many small injuries over time add up to the same risk as one massive injury is a known issue with these kinds of calculations,” he stated.
The Role of CT Scans in Medical Emergencies
Despite the dangers of radiation exposure, CT scans are an important component to quickly diagnosing and treating time-sensitive, life-threatening emergencies. They account for providing critical information in minutes, helping make time-sensitive decisions in emergencies like strokes, internal bleeding, or appendicitis. Bashir noted that when CT scans are clearly indicated, “the benefits likely far outweigh the risks.”
To make sure that only necessary scan protocols are used, he suggested that patients be empowered to articulate their symptoms to radiologic technologists. Advancing this dialogue will better allow tailoring the imaging process to medical needs. Bashir suggested patients inquire as to how many phases are going to be included in their scan. This hidden detail can have a major influence on the accuracy of the resulting images and level of radiation dose.
“Patients should ask the technologist to consult the radiologist about potentially limiting the scan to a single phase if more than one phase is indicated,” Bashir suggested. This process reduces unnecessary exposure and adds an extra layer of patient safety as well.
Advancements in Imaging Technology
Bashir points to one big success story—the substantial decrease of radiation doses from CT scans. This big success hasn’t happened overnight, though. He made the point that today’s doses are “very low compared to what they used to be.” He’s pegged this decline largely to the ongoing improvement of imaging technology. On average, radiation doses from CT scans are reduced every three to five years as new techniques are developed and adopted.
Bashir nonetheless anticipates a decrease in the average radiation dose from CT scans within five years. He feels comfortable saying that it will be lower than current levels. This optimism comes from continuous research and development efforts to advance imaging techniques without compromising diagnostic effectiveness.
Further, Bashir said, this is cruel when screenings are repeated. It’s a concern of his, particularly when patients require annual or more frequent scans over long stretches of time. “The times we might get concerned are in repeated screening,” he cautioned. When this would be the case, he argued for recognizing when alternatives are available, including magnetic resonance imaging (MRI), which avoids any radiation exposure.
Navigating Patient Conversations About CT Scans
CT scans are not without their complexities and risks. That’s why open communication between patients and their healthcare providers is so important. Rebecca Smith-Bindman, a leader in radiology research, underscored the need for patients to be engaged and active in their medical conversations.
Smith-Bindman stressed the need to be actively involved in the discussion. In this manner, you can ensure that you receive the advocacy and information required for the care you deserve. She urged patients to ask their doctors what the clinical rationale is for their imaging and to know what risks—if any—are associated with it.
Smith-Bindman highlighted that CT scans are often used because patients want reassurance from their doctors. They need to understand the slight cancer risk entailed, particularly when their clinician has said there’s little chance of discovering useful information. “It’s important to understand the clinical question behind the imaging,” she added.
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