Are Americans Getting Too Much Radiation? FDA to Investigate

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Today and tomorrow the US Food and Drug Administration will hold meetings with industry and healthcare experts to evaluate the exposure of Americans to radiation, which has doubled in the last three decades largely in part to imaging procedures such as CT scans. The agency has been blamed by some professional groups for not being proactive enough on this issue.

Specifically, the FDA will seek ideas to get manufacturers of diagnostic imaging devices such as CTs and fluoroscopy to set higher standards for their equipment or come up with alternative procedures to reduce unnecessary patient exposure to ionizing radiation. A recent study published in the April 2010 issue of the American Journal of Roentgenology found that padding, or shortening the time window in which images are acquired, can reduce radiation exposure from CT scans during angiography.

They also want to increase the amount of training offered to those who use the equipment to further increase patient safety. A study last year from the Annals of Internal Medicine found that there was not a consistent level of radiation that patients received for angiograms and that it was based on the level chosen by the lab technician. Some patients in the study received up to 22 times the exposure as other patients.

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Physicians such as Dr. Jorge Guerra Jr, professor of radiology at the University of Miami Miller School of Medicine stress that there also need to be clearer guidelines for the use of CT and other radiological devices. “Yes, there is an increased risk of cancer in the general population from the overuse of radiation,” he said, “Let’s work on cutting down the overuse of radiation, not cutting out the technology.”

CT scans and fluoroscopy are the two of the top three contributors to total radiation exposure among Americans. These tests use more radiation than standard x-rays, dental x-rays, and mammography. The radiation from a CT scan of the abdomen, for example, equals that of about 400 chest x-rays. In addition to the increased lifetime risk of cancer, radiation exposure can result in injuries such as burns, hair loss and cataracts.

According to the U.S. National Cancer Institute, about 70 million CT scans are performed in the United States each year, up from 3 million in the early 1980’s. The NCI also estimates that up to 14,000 people die every year from radiation-induced cancers.

In February, the FDA agreed to better communicate standards for imaging procedures to doctors and health care facilities. The acknowledge that diagnostic imaging procedures have led to disease being diagnosed earlier and allowing better treatment options, however they did ask that doctors and patients keep two principles in mind: that each procedure be justified and that the radiation be given at the minimum dose required. In some cases, an alternative such as MRI or ultrasound, which do not use radiation, can be used.

The American Cancer Society recommends that Americans be aware of all forms of radiation that they are exposed to on a daily basis. Some are not controllable, such as that from cosmic rays from space or radon gas in the soil. It is for this reason that each patient evaluates the controllable sources of radiation, such as decreasing the number of unneeded imaging tests.

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