Radiation exposure has been in the news lately with the recent events in Japan, making the public more aware of possible radiation hazards from other sources. A study published recently in the Archives of Internal Medicine, meanwhile, included some interesting news about chest X-rays. People with pneumonia who are age 50 younger and don’t smoke don’t necessarily need chest X-rays.
Most medical diagnostic guidelines recommend an X-ray for all patients with pneumonia. This is because a mass (cancer) in the lungs can theoretically obstruct the lungs and cause pneumonia. But a study published in April suggests that these guidelines may be too broad.
The study at the University of Alberta in Edmonton followed about 3,400 patients who were treated for pneumonia in their city between 2000 and 2002. Just over 1 percent of all the pneumonia patients were diagnosed with lung cancer based on an X-ray in those 3 months after diagnosis of pneumonia. This increased to 2.3 diagnosed with X-rays given over the next five years. Not surprisingly, no patients younger than 40 got lung cancer during those five years of follow-up.
This led to the study’s recommendation that X-rays be performed on pneumonia patients who were over 50 and/or smoked.
How much radiation is in a single chest X-ray? Not a whole lot, but why get an X-ray if you don’t need it?
Diagnostic X-rays are the largest man-made source of radiation exposure to the general population, contributing about 14 percent of the total annual exposure worldwide from all sources.
A study published in 2004 in Lancet researched the risk of development of cancer with diagnostic X-rays in 14 countries. The researchers found that 0.6 percent to 3 percent of the cumulative risk of cancer to age 75 could be attributable to diagnostic X-rays in the countries studied.
The U.S. Nuclear Regulatory Commission recommends that beyond background radiation, the average person should limit exposure to less that one millisievert a year. A single CT scan, for example, can expose the patient to one millisievert. However, the radiation risks need to be weighed with the medical benefits of performing the diagnostic X-ray.
Take-home message for the average patient? Be aware of radiation risks when getting diagnostic X-rays. Discuss the risks/ benefits of diagnostic tests with your physician, especially when getting tests that expose you to high levels of radiation.
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