News | January 02, 2013

Immediate Health Risk Must Be Weighed Against Radiation-Induced Cancer Risk

January 2, 2013 — The lifetime risks of cancer from medical radiation may be overemphasized relative to more immediate health risks, according to a new clinical study published online in the journal Radiology.

Radiation exposure from computed tomography (CT) and other medical sources has drawn considerable media attention in recent years. Stories warning of the dangers often focus on the lifetime risk estimates of radiation-induced cancer from repeat examinations. This approach has limitations, said Pari V. Pandharipande, M.D., M.P.H., abdominal and genitourinary imaging specialist at Massachusetts General Hospital and Harvard Medical School in Boston, especially in regard to clinical decision making.

Physicians often order imaging exams to diagnose, treat or monitor life-threatening conditions. The immediate or near-term risk of death from the condition should be taken into account when weighing the benefits of an exam against a potential future risk of radiation-induced cancer from imaging.

“This must be considered when physicians make imaging decisions for their patients, because the timing of risks changes their relevance,” Pandharipande said. “Risks incurred later in life are not the same as those faced in the present. If you had to choose between the chance of incurring a serious risk now or later in life, most people would choose the latter.”

Pandharipande and colleagues recently used CT radiation dose data and mathematical models to better understand the risk-benefit dynamic of medical radiation. They projected outcomes for testicular cancer patients who undergo CT surveillance in the decade after orchiectomy, or removal of the testicle. 

“Testicular cancer affects younger men, and patients treated for early-stage cancer receive several CT scans during surveillance,” Pandharipande said. “These patients do very well, but they have a greater risk of radiation-induced cancer later in life.”

Based on the results of their analysis, the researchers projected that 33-year-old men with early-stage cancer who undergo CT surveillance incur a slightly higher lifetime mortality risk from testicular cancer compared with potential radiation-induced cancers. Because the testicular cancer risk was more immediate, life expectancy loss attributable to testicular cancer was more than three times greater than life expectancy loss attributable to radiation-induced cancers.

The trends were consistent across all the scenarios studied, and put forth a useful concept to help physicians with decision making.

“Radiation-induced cancer risks, often discussed at the population level, can be challenging to conceptualize and apply to imaging decisions that have to be made at the patient level,” Pandharipande said. “We as physicians can benefit from dedicated educational efforts to improve decision making and better convey the risks to patients.”

Although the study focused on testicular cancer patients, concepts pertaining to the timing of radiation-induced cancer risk translate to other scenarios where CT is needed to avert a more immediate health risk, Pandharipande noted.

 “Patients with Testicular Cancer Undergoing CT Surveillance Demonstrate a Pitfall of Radiation-induced Cancer Risk Estimates: The Timing Paradox.” Collaborating with Pandharipande were Jonathan D. Eisenberg, B.A., Richard J. Lee, M.D., Ph.D., Michael E. Gilmore, M.B.A., Ekin A. Turan, B.S., Sarabjeet Singh, M.D., Mannudeep K. Kalra, M.D., Bob Liu, Ph.D., Chung Yin Kong, Ph.D., and G. Scott Gazelle, M.D., M.P.H.

For more information: RadiologyInfo.org.

Related Content

Novel Technique May Significantly Reduce Breast Biopsies
News | Breast Biopsy Systems | January 17, 2019
A novel technique that uses mammography to determine the biological tissue composition of a tumor could help reduce...
Digital Mammography Increases Breast Cancer Detection
News | Mammography | January 16, 2019
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United...
Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
3-D Reconstruction of Ichthyosaurus Skull

A 3-D reconstruction of the ichthyosaurus skull from a computed tomography (CT) scan. Image courtesy of Nigel Larkin, taken at Royal Veterinary College, London.

News | Computed Tomography (CT) | January 09, 2019
A nearly meter-long skull of a giant fossil marine ichthyosaur found in a farmer's field more than 60 years ago has...
SCCT Releases New Guideline for CT Use During TAVR
News | Computed Tomography (CT) | January 08, 2019
The Society of Cardiovascular Computed Tomography (SCCT) has released a new expert consensus document for computed...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...