Private firms told to stop offering full body scans
Publication Date:21/12/2007
Private firms should stop offering full body scans to healthy people with no signs of disease, says a committee that advises the government on the risks of radiation. They also say that anyone with symptoms who asks for a private scan should be told to see their GP instead.
What do we know already?
Computed tomography (CT) X-ray scans are used widely in medicine to help with the diagnosis and treatment of many conditions. For example, if you have been diagnosed with bowel cancer, your doctor may suggest you have a CT scan to see exactly how big the tumour is and whether it has spread. CT scans are also used to see how someone is responding to treatment: for example, if their tumour has shrunk after chemotherapy.
CT scans use X-rays to create pictures of the inside of your body from many different angles. Modern scanners produce 1,000 pictures of your body in under 30 seconds. These are processed by a computer to produce images that look like slices of your body (called 'cross-sectional views'). They can show organs, bone, tissues and blood vessels.
At the moment, 90 percent of CT scans are done on NHS patients. But there is an increasing trend for people with no symptoms to pay for scans to be done by private firms. These can cost hundreds of pounds. Various different types of CT scans are available. For example, you can get a scan of just your lungs, your heart or your bowels. Some firms offer full body scans, in which your chest, abdomen and pelvis are all scanned for signs of disease (this is different to a full body scan offered in the US, where your entire body, including your brain, head and limbs, is scanned). These types of scans are designed to reassure people that they are healthy and do not have cancer or a heart condition that is not yet causing any symptoms.
In 2005, the Department of Health asked an independent body called the Committee on Medical Aspects of Radiation in the Environment (COMARE) to look at whether CT scans in people who have no symptoms of disease are safe and worthwhile.
What does the new report say?
The new report says that private firms that offer whole body scans to people with no symptoms should stop doing so immediately. It says there is very little evidence that having one of these scans outweighs the potential risk of having a significant dose of radiation from the scan.
The report also says private firms should stop using CT scans to test for lung cancer, as there is no evidence that scanning people with no symptoms is beneficial. In addition, CT scans should not be used to assess conditions that affect the spine, or to check for osteoporosis and body fat. That's because there are better tests for those conditions, which do not involve the same exposure to radiation.
In some situations, CT scans may be beneficial, the report says. Certain people who are found to be at high risk of heart disease may benefit from a CT scan that looks at the amount of calcium in the arteries. But these scans should not be done more than once every three years. There may also be a role for CT scans of the colon in people over 50, although people with a family history of colon cancer should be seen in a specialist genetics unit.
Tell me more about what the report says
The report says that, although the radiation risk for a scan is low, people need to be aware that the risk exists. A typical scan is associated with a 1 in 2,000 risk of getting cancer over a lifetime. The report estimates that if 100,000 people had a scan every five years from the age 40 to 70, there would be an extra 240 deaths from cancer caused by radiation from the scan.
The report says that CT scans can also cause unnecessary worry. Scans can detect lumps that turn out to be harmless. They might be benign tumours that don’t turn into cancer, or they may be very slow-growing cancers that are not dangerous. But if a scan detects lumps, you need more tests to be sure there is nothing seriously wrong. This causes you anxiety and creates costs for the NHS that wouldn't be needed if you'd never had the scan.
Where does the report come from?
The report comes from the Committee on Medical Aspects of Radiation in the Environment (COMARE). This organisation was set up in 1985 to advise governments in the UK about the effects of radiation on health.
What does this mean for me?
If you are healthy with no signs of illness and have been thinking about having a whole body scan, then the recommendations in this report are important for you. You may need to think about why you are having a scan and how you hope you might gain from it.
What should I do now?
If you have been thinking about paying for a private CT scan, either of your whole body or of just one part of your body (such as your lungs), you need to think about whether this scan might help you. For example, there is no evidence that having one of these scans can detect lung cancer early and reduce the chance of dying from it. If you’re worried you may be at high risk of getting a disease, say colon cancer because a close relative has had it, you should speak to your GP.
CT scans are expensive. Although they’re designed to reassure, they can create anxiety. Before you book in for one of these scans, ask your GP if you are likely to benefit from having a CT scan. Your doctor will be able to advise you on whether a CT scan is the right course of action for you.
Committee on Medical Aspects of Radiation in the Environment (COMARE). Twelfth report. The impact of personally initiated X-ray computed tomography scanning for the health assessment of asymptomatic patients. Available at www.comare.org.uk (accessed on 20 December 2007).
To find out more about some of the conditions mentioned in this article, see our information on colon and rectal cancer, heart attacks and lung cancer.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
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