X-ray - Adverse Effects

Adverse Effects

Diagnostic X-rays (primarily from CT scans due to the large dose used) increase the risk of developmental problems and cancer in those exposed. X rays are classified as a carcinogen by both the World Health Organization's International Agency for Research on Cancer and the U.S. government. It is estimated that 0.4% of current cancers in the United States are due to computed tomography (CT scans) performed in the past and that this may increase to as high as 1.5-2% with 2007 rates of CT usage.

Experimental and epidemiological data currently do not support the proposition that there is a threshold dose of radiation below which there is no increased risk of cancer. However, this is under increasing doubt. It is estimated that the additional radiation will increase a person's cumulative risk of getting cancer by age 75 by 0.6–1.8%. The amount of absorbed radiation depends upon the type of X-ray test and the body part involved. CT and fluoroscopy entail higher doses of radiation than do plain X-rays.

To place the increased risk in perspective, a plain chest X-ray will expose a person to the same amount from background radiation that we are exposed to (depending upon location) every day over 10 days, while exposure from a dental X-ray is approximately equivalent to 1 day of environmental background radiation. Each such X-ray would add less than 1 per 1,000,000 to the lifetime cancer risk. An abdominal or chest CT would be the equivalent to 2–3 years of background radiation to the whole body, or 4–5 years to the abdomen or chest, increasing the lifetime cancer risk between 1 per 1,000 to 1 per 10,000. This is compared to the roughly 40% chance of a US citizen developing cancer during their lifetime. For instance, the effective dose to the torso from a CT scan of the chest is about 5 mSv, and the absorbed dose is about 14 mGy. A head CT scan (1.5mSv, 64mGy) that is performed once with and once without contrast agent, would be equivalent to 40 years of background radiation to the head. Accurate estimation of effective doses due to CT is difficult with the estimation uncertainty range of about ±19% to ±32% for adult head scans depending upon the method used.

The risk of radiation is greater to unborn babies, so in pregnant patients, the benefits of the investigation (X-ray) should be balanced with the potential hazards to the unborn fetus. In the US, there are an estimated 62 million CT scans performed annually, including more than 4 million on children. Avoiding unnecessary X-rays (especially CT scans) will reduce radiation dose and any associated cancer risk.