Has F.D.A. Ignored Radiation Warnings?
Imaging techniques are so seductive: take a picture of the inside of the body and diagnose. Seems simple. Unfortunately, there are serious risks in imaging and sometimes they can lead to cancer and even death.
I am old enough that I have friends who died as a result of an earlier infatuation with X-rays. At one time, Buster Brown shoe stores had X-rays machine in their stores as a marketing gimmick and many children would run down to their stores to look at their feet in X-ray images.
An estimated 70 million CT (for computed tomography) scans are performed in the United States every year, up from three million in the early 1980s, and as many as 14,000 people may die every year of radiation-induced cancers as a result, researchers estimate.
The use of CT scans to screen healthy patients for cancer is particularly controversial. In colon cancer screening, for instance, the American College of Radiology as well as the American Cancer Society have endorsed CT scans, in a procedure often called a virtual colonoscopy, while the American College of Gastroenterology recommends direct examinations in which doctors use a camera on a flexible tube.
For patients, navigating the debate can be difficult because doctors, patient advocacy groups and manufacturers often endorse positions that are in their economic self-interest. Radiologists, who often own and use CT machines, for instance, often endorse their use; while gastroenterologists, who often own and use camera scopes, often favor their own methods. Patient groups often get financing from drug and device makers, or physician-specialty groups.
The Food and Drug Administration, charged with sorting out such competing claims, has been just as torn on the issue. The internal dispute has grown so heated that a group of agency scientists who are concerned about the risks of CT scans say they will testify at the Tuesday meeting that F.D.A. managers ignored or suppressed their concerns, and that the resulting delay in making these concerns public may have led hundreds of patients to be endangered needlessly.