The rates of scans for both groups remained stable in 2006 and 2007 and then began to decline.
“The increased use of CT in pediatrics, combined with the wide variability in radiation doses, has resulted in many children receiving a high-dose examination,” the study's authors wrote.
Other studies based on government data have shown that the use of CT scans among adults also rose at significant rates during a similar timeframe.
MRIs, PET and CT scans tripled from 1996 to 2007, according to the Centers for Disease Control and Prevention. A separate study found that CT scans ordered during emergency report visits jumped from 2.7 million in 1995 to 16.2 million in 2007.
Increased use of diagnostic imaging, in addition to several instances of radiation overdoses, has led to increased awareness and new protocols for how and when imaging should be utilized. However, the study's authors noted that it is unknown whether recommendations to lower radiation doses for CT scans performed on children have been widely implemented.
Image Gently, a campaign launched in 2008 by the Alliance for Radiation Safety in Pediatric Imaging, has sought to encourage dose reduction among healthcare providers. In addition, the American Academy of Pediatrics recently said in its Choosing Wisely campaign contribution that CT scans are not necessary when immediately evaluating minor head injuries in children.
“Implementation of these readily available dose-reduction strategies, combined with the elimination of unnecessary imaging, could dramatically reduce future radiation-induced cancer from CT use in pediatrics,” the authors conclude.
When compared to adult patients, children are more sensitive to radiation-induced carcinogenesis and have more years for the cancer to develop.
About 5% to 11% of the 85 million CT scans in 2011 were performed on children. The authors estimate that around 5,000 future cancers could be caused by the roughly 5 million pediatric CT scans that are performed each year.
The authors also conclude that girls and younger patients, as well as patients who received CT scans of the abdomen and pelvis or spine, are likely to have higher risks of developing radiation-induced cancer. Radiation doses varied for each examination.
JAMA Pediatrics noted in a separate editorial that other issues tied to increased CT scans in pediatric patients can include unnecessary financial costs, the need for sedation in certain instances, additional testing that stems from false-positive reports and overdiagnosis.
The editorial's authors advise that providers should aim to reduce unnecessary scans as well as decrease radiation exposure in necessary images.
“This will require a shift in our culture to become more tolerant of clinical diagnoses without confirmatory imaging, more accepting of 'watch and wait' approaches, and less accepting of the 'another test can't hurt' mentality,” they said. “Uncertainty can be unsettling, but it is a small price to pay for protecting ourselves and our children from thousands of preventable cancers.”
Follow Jaimy Lee on Twitter: @MHjlee
