SIDEBAR: Expect Questions from Parents

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Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians.

“The three key questions that parents can ask are: (1) Why is the test needed? (2) Will the results change the treatment decisions? and (3) Is there an alternative test?” noted the study’s senior author Amy Berrington de González, PhD, Senior Investigator, Division of Cancer Epidemiology and Genetics at the National Cancer Institute (NCI). “If the test is clinically justified, then parents can be reassured that the benefits will easily outweigh the small long-term risks,” she said.

Studies in which parents were given information regarding the risks and benefits of CT have shown that this did not result in reduced compliance, according to Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, published by the NCI. This approach did result in parents asking more informed questions of the care providers.

The American College of Radiology (ACR) urged that the results of the study “should not keep parents from getting needed medical imaging care for their children, but should be discussed with their physician and factored into their shared decision-making before an imaging scan is performed.” The ACR statement also recommended that parents keep a record of their child’s x-ray history.

“Parents should certainly discuss risk with their provider, but not refuse care that may save and extend their child’s life,” commented Marta Schulman, MD, Chair of the ACR Pediatric Imaging Commission. ■

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