Researchers cite 'dramatic' increase in CT scans for kids

Even though the appendicitis rate for kids hasn't gone up, the percentage of children who get CT scans after going to the ER for stomach pain has skyrocketed, raising cancer concerns.

Of all the kids who go to emergency rooms in the U.S., about 6 percent are there because of stomach pains, according to researchers analyzing a large national database.

This abdominal CT scan reveals cysts. Steven Fruitsmaak

And while that 6 percent rate has held steady over the past decade, with anywhere from 2 percent to 8 percent being diagnosed with appendicitis (the number fluctuated without any clear pattern), the percentage of kids getting CT scans has jumped from 0.9 percent to 15.4 percent between 1998 and 2008, the researchers wrote in the current issue of the journal Pediatrics.

"That is basically saying for every six or seven kids that go to the ER for bellyache, one is going to get a CT scan," Dr. Jahan Fahimi, an emergency physician at the University of California, San Francisco, who led the new work, told Reuters Health.

Fahimi added that while the risk of a CT scan causing cancer is largely unknown, "I tell my patients that the CT scan I do today has a chance of causing cancer at some point down the road. That risk may be one in 500, it may be one in 1,000, but it's not zero."

A report from 2009 found that the rate of CT scans in adults was up fourfold over the previous 15 years, with as many as 2 percent of cancers being attributed to radiation during CT scans.

Meanwhile, the rate of other imaging techniques on children, such as x-rays and ultrasounds, has not changed. CT scans, or computed tomography scans, can cost several hundred dollars, and were more frequently performed on insured children.

Fahimi said the rise in CT scan use could be related to doctors protecting themselves from malpractice lawsuits that can result from not identifying appendicitis, although this would not explain why the rate of ultrasounds, which can also diagnose appendicitis, did not rise.

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About the author

Elizabeth Armstrong Moore is based in Portland, Ore., and has written for Wired, The Christian Science Monitor, and public radio. Her semi-obscure hobbies include climbing, billiards, board games that take up a lot of space, and piano.

 

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