Even though offering CT scanning – using a computed tomography X-ray machine – on healthy individuals might provide some benefits to the person concerned in some cases, it is a practice which has an impact on public health, says COMARE (Committee on Medical Aspects of Radiation in the Environment). COMARE is an independent expert committee which advises the UK government, its members are chosen for their medical/scientific expertise and recruited from Universities, Research and Medical Institutes – its member are never recruited from the Nuclear or Electrical Power Supply industries.
This latest report comes after COMARE examined studies and reports which showed both the benefits and detriment linked to commercial CT scanning of asymptomatic people. The committee also looked at the psychological effects of the practice, as well as the potential physical detriment from further investigations. As the National Health Service (NHS) may become liable for further examinations and tests, the economic implications for the NHS were also reviewed. The committee members also reviewed alternative techniques which use lower doses of ionizing radiation or non-ionizing radiation.
The Committee recommends that there should be a review of the regulations that govern the practices of commercial CT services. Users should be provided with full information regarding doses and risks linked to CT scanning, as well as what their chances are of getting a false negative or false positive finding.
Commercial CT services should have well developed and confidential mechanisms for integrating examination results into an established care pathway – data relating to scans should be in formats which are consistent with NHS IT programs.
COMARE also recommends that a person who displays symptoms and wants a commercial CT scan should be referred back to his/her GP – in other words, not be scanned first. Regulations require that all medical exposures using ionizing radiation should be optimized. According to COMARE’s review, it is not possible to optimize exposure parameters for CT scans of the whole of the body. Therefore, services should stop offering whole body CT scans for healthy individuals (people without symptoms).
The Committee ads that commercial CT scans should not be used to assess spinal conditions, body fat, and osteoporosis in healthy people.
COMARE sees no benefit in CT scanning for lung conditions. It sees benefit in cardiac CT scanning for predicting cardiovascular risk, while CT colonography can also detect small lesions. Therefore, cardiac CT scanning and CT colonography should only be carried out on some people who have symptoms.
“TWELFTH REPORT – The impact of personally initiated X-ray computed tomography scanning forthe health assessment of asymptomatic individuals” (PDF)
Chairman: Professor A Elliott
Written by – Christian Nordqvist