I’ve recently been looking over the statistics about this blog. The most popular posts are those which talk about common issues — croup and concussions, for example. But one of the most often read posts gets its popularity from people using search engines like Google to answer this question: how risky are x-rays, especially CT scans, to children? You can read my actual posts about that here and here, but what struck me most about the popularity of this topic is what it tells us regarding how we think about risk. In particular, how do we tend to think about the risk of events occurring which are very rare, but which carry grave consequences if they happen? Lawyers call these events “small probability — large loss events.” Economists have studied the subject quite a bit, too, especially as it relates to investment decisions people make.
We humans are not entirely rational when we think about risk. We tend to focus on low-probability but high seriousness events, particularly if we are thinking about them in the context of choosing to do or not do something. So, for example, if your child needs a CT scan, as a parent you many think about how the radiation in that test increases your child’s chances of getting cancer. What we don’t think about is that your child is far, far more likely to suffer harm in a car accident while you are driving to the CT scanner than he is to suffer harm from the scan. But since we drive our children around every day, we don’t think much about that risk.
According to the National Cancer Institute, a child’s overall risk of developing any form of cancer is 1-2/10,000 children, or 0.01-0.02%. Also according to the NCI, this number has changed very little, if at all, over the past 30 years. The use of diagnostic x-rays in children, especially CT scans, has increased enormously during that time, so we should be reassured by these statistics. Even so, radiologists are increasingly vigilant about how they can reduce radiation exposure when they use x-rays.
Bottom line — it is always worth asking if the risk of a test exceeds the value of the information the test will give. But for x-rays, the benefit virtually always outweighs the risk.
- CT scans and cancer: thinking about the meaning of risk Facebook Twitter Google+ LinkedIn I’ve written before about how to...
- New information about radiation from CT scans and cancer risk Facebook Twitter Google+ LinkedIn 1 I’ve written before about the...
- CT scans and radiation risk Facebook Twitter Google+ LinkedIn I’ve written before about the radiation...
- Are x-rays completely safe? Facebook Twitter 6 Google+ LinkedIn Doctors do a lot of...
- Overdiagnosis: how our compulsion for diagnosis may be harming children Facebook Twitter Google+ LinkedIn A recent article in the journal...
Leave a Reply
08/19/2013 • Many, myself included, have written about the overuse of head computed tomography (CT) scanning in children. This concern has become more focused now that we have some data on the radiation risk of those scans. ...more
06/08/2013 • I've written before about the increased risk for future cancer, if any, of diagnostic radiation (here , here, and here). These posts have generated a large number of comments and questions from parents. Most take ...more
10/05/2012 • The sinuses are air-filled cavities in our skulls. They are important for a couple of reasons. For one thing, they help warm and humidify the air we breathe in through our nose. For another thing, ...more
08/22/2011 • Nearly everyone has heard about the medical malpractice controversy. Most doctors call it a crisis, saying, among other things, that physicians are retiring early because of it or altering their practice -- not taking on ...more