Guidelines on getting or avoiding scans

In last week’s post I mentioned that various types of scans and x-rays can be both dangerous and of no value. Of course, often they are needed for diagnostic purposes—but often they’re not. The following is a summary of what the March 15, 2015 issue of Consumer Reports offers as guidelines for making decisions about getting scans or x-rays.

Four scans you can usually skip:

•  X-rays for back pain: Back pain is usually caused by muscle damage and clears up on its own. Unless your doctor suspects a serious underlying problem such as cancer or a spinal infection, or severe nerve damage, an x-ray is not usually needed.
•  Chest x-rays before surgery: You don’t need to be “cleared” for surgery with an x-ray unless your surgery involves the heart, lungs, or part of the chest.
•  CT scans to screen for lung cancer: The test is worthwhile only for people at the highest risk of developing lung cancer, which includes current or former smokers between the ages of 55 and 80 who smoked the equivalent of a pack a day for 30 years.
•  CT scans for headaches: A CT scan for headaches is necessary only if your doctor can’t diagnose your problem based on a physical exam, which he or she almost always can. However, if your headache is sudden or explosive or accompanied by fever, seizure or vomiting, a scan is warranted—but not a CT scan, which exposes you to radiation. Get an MRI instead.

 Cancers from medical radiation can take anywhere from five to 60 years to develop. Children are particularly vulnerable to the effects of radiation. Those who had a CT scan before the age of five face a 35 percent spike in cancer risk. For every 1,000 children who have an abdominal CT scan, one will develop cancer as a result. A 2012 study that looked at almost 180,000 British children linked CT scans to higher rates of leukemia and brain cancer. Dr.Stephen J. Swensen, M.D., medical director at the Mayo Clinic in Rochester, Minnesota says, “All too often children are receiving adult-sized doses of radiation, which is many times the amount they need. The dose directly increases the risk of leukemia or a solid tumor. And that’s not regulated today.” A friend of mine developed cancer of the salivary gland which she suspects (with good evidence) was caused by X-ray treatments for acne she received as a teenager over 50 years ago.

As to X-rays on your teeth (the bitewing type), you need one only every 24 to 36 months, and you can go a decade between full-mouth x-rays.

Well, this is scary business. Best to be skeptical when it comes to getting scans.

Next week: Mammograms: Just say no

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.