Tuesday, June 10th, 2014
Most children who get multiple X-ray and CT scans because of heart disease don’t face a significantly higher risk of developing cancer later in childhood because of the scans’ radiation, according to new research conducted by Duke University cardiologists. Some kids–especially girls–do face a higher risk of cancer than others, so doctors are urged to take steps to reduce the radiation exposure from the scans. More from NBC News:
It’s an issue because children are three to four times more likely to develop cancer from exposure to ionizing radiation like that given in an X-ray or computed tomography (CT) scan. “Radiation exposure in childhood is of particular concern because children have immature developing organ and tissue structures,” Hill’s team wrote in their report, published in the journal Circulation.
These kids got an awful lot of imaging — 13,932 X-rays, CT scans and other procedures before, during and after surgery. The X-rays didn’t deliver much radiation at all, Hill’s team found.
The big culprits are cardiac catheterization exams and CT scans. They can deliver up to 1,800 times more radiation than a standard X-ray. Children who got many of these complicated and time-consuming scans did get enough radiation to triple their risk of cancer, Hill found.
On average, children don’t have a high risk of cancer, though, so even doubling or tripling that very low risk still doesn’t make them very likely to develop cancer.
“Even though their risk is threefold greater, it is not necessarily a high risk,” Hill said. “I think it is important for parents to understand that there is a small amount of risk.”
Doctors can and should do their best to minimize radiation exposure, Hill said. New technology can help with this, as can techniques that make it necessary to use the shortest possible burst of radiation.
Image: Chest X-ray, via Shutterstock
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Thursday, December 12th, 2013
A new study from Dartmouth University researchers has found that kids who grow up in different cities and towns are more or less likely to receive different types of health care such as tonsil removals or CT scans. The research paints a confusing picture of standards of care for young patients, as Reuters reports:
Children in Lebanon, New Hampshire, are more than twice as likely to have their tonsils removed as those in Bangor, Maine. Kids in Lewiston, Maine, are 50 percent more likely to have a CT scan of their head than are kids in Portland, Maine, or Lebanon and Burlington, Vermont.
Lebanon’s children don’t have especially infection-prone tonsils, and Lewiston’s don’t fall on their heads more than kids elsewhere do. Instead, according to a report released on Wednesday, the glaring variation means that in some cases “children are not receiving enough good care,” said pediatrician and health policy analyst Dr David Goodman of the Geisel School of Medicine at Dartmouth University, who led the study for the Dartmouth Atlas Project. But in other cases they “may be receiving unnecessary care that is harmful.”
Similar research from the project has shown that the rate of medical procedures performed on older Americans covered by Medicare varies enormously depending on where they live.
The new report, which focused on northern New England, is the first to show that geographic variability exists in children’s healthcare, too, raising questions about why tens of thousands of kids are not receiving recommended care such as screening for lead poisoning and why tens of thousands of others are subjected to potentially unneeded treatments such as CTs for stomachaches.
The Dartmouth Atlas was able to examine geographic variations in the medical care provided to children in Maine, New Hampshire and Vermont from 2007 to 2010 because those states are among the few that collect data on all health insurance claims, which the researchers analyzed.
“This suggests that there is a significant amount of overuse of medical services in some areas,” said Dr Vikas Saini, a cardiologist and president of the Lown Institute, a healthcare think tank in Boston. “Especially because unneeded care can expose children to harmful side effects, this is very troubling.”
Image: Child having throat exam, via Shutterstock
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Wednesday, June 12th, 2013
Children who receive multiple CT scans, which expose them to radiation, are at a higher risk of developing cancer later in life, a new study published in JAMA Pediatrics. More from NBC News:
While CT scans provide “beautiful 3-D pictures of the inside of the body,” they also subject patients to a significant amount of radiation, which may boost the risk of future cancer, said the study’s lead author Diana Miglioretti, a professor of biostatistics at the University of California, Davis, and a senior investigator at the Group Health Research Institute.
Between 1996 and 2006 CT scans in children under age 5 nearly doubled, while they almost tripled in kids aged 5 to 14 years, according to the report in JAMA Pediatrics. While the number of scans in children has declined since 2006, it’s still much higher than in 1996.
While the researchers suspect many of those scans could be avoided, for some kids, like 5-year-old Dezhan Frajer, the clearer 3D images that come from CT are the only way to figure out what’s wrong. Dezhan has been suffering from some complicated ear and eye symptoms, and his mom, Tamika is hoping his scans will explain what’s going on.
CT scans are often used in kids when appendicitis is suspected or to rule out severe damage when children hit their heads hard or if there is concern that the spine has been injured. They are also used to diagnose brain tumors and other abnormalities.
CT scans became more popular because, “it is a great tool and is very sensitive and accurate,” Miglioretti said.
Miglioretti and her colleagues scrutinized data from six large HMOs. Included in the study were data from 152,419 to 371,095 children each year. They found CT scan use jumped between 1996 and 2005, remained stable until 2007, and then started to decline.
Even with the decline, in 2010 scans were still being done at nearly two and a half times the rate of 1996 in children aged 5 to 14 and one-and-a-half times the 1996 rate in children under age 5.
Image: Pediatric CT scan, via Shutterstock
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