KevinMD blogs about a recent article in the Archives of Internal Medicine concluding that “roughly 72 million CT scans performed in the U.S. in 2007 will ultimately cause some 29,000 cases of cancer.”
These figures are not surprising to radiographers or radiologists in the EU, where radiation protection forms an integral part of training. We're trained to expect that any exposure to ionizing radiation needs to be justifiable. I've never worked in the USA, but anyone I know who has says that this culture of justifying radiation exposure to patients is not as well developed there.
But even here in Europe, the discussion regarding these investigations and interventions are held between referring physicians and radiographers/radiologists. The patient is by and large completely removed from the debate. Why is this the case? Surely this is the kind of paternalism modern medicine has moved away from? We involve patients in ever more detailed discussion of risk/benefit ratios when it comes to their medications or proposed surgeries, but why do we not discuss the risks of ionizing radiation with them?