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Certain Tests in ERs Raise Cancer Risk for Some


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In this case, Bullard and his colleagues focused on a five-period of diagnostic testing exposure among a randomly selected group of patients attending the emergency rooms at ORMC and Washington Hospital.

The researchers found that most patient radiation exposure stemmed from CT scans and nuclear medicine testing, with patients averaging a cumulative radiation dose calculated as 40 milliseiverts (mSV) over the five-year study period.

By way of comparison, Bullard noted that 200 mSV was the average exposure level observed among Nagasaki and Hiroshima atom bomb survivors within a 2.5 kilometer-radius of each bomb epicenter. Ten percent of the study patients averaged half that amount -- or 100 mSV -- spread over the five years of the study.

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The research team concluded that such figures meant that if the patient pool with whom they worked can be considered representative of the general ER population in the United States, then a significant slice of ER patients may be at an increased risk for developing cancer as a result of cumulative diagnostic radiation exposure.

Bullard pointed out that with specific respect to patient radiation exposure, in the United States there are no firm federal standards, cut-offs or recommendations.

"There are exposure safety standards for people in industries who work around radiation," he noted. "But in the past, patients per say were not typically considered to be an issue, because it was assumed they weren't exposed to radiation so much. But I think that has changed."

Backing up Bullard's perceptions and concerns is a Columbia University study published last fall in the New England Journal of Medicine, in which researchers noted that the number of CT scans being performed in the United States has skyrocketed over the past couple of decades.

In that publication, lead researcher David J. Brenner estimated that more than 62 million CT scans are now performed each year, up from just 3 million in 1980 -- despite the observation that upwards of one-third of all such scans are, in fact, medically unnecessary.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 5/29/2008

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SOURCES: Timothy Bullard, M.D., chief medical officer, Orlando Regional Medical Center, Fla.; James E. inslow, M.D., assistant professor, Baptist Medical Center, Winston-Salem, N.C.; May 29, 2008, presentation, Society for Academic Emergency Medicine annual meeting, Washington, D.C.


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