Last night I was reading about the latest Iressa (gefinitib) data in lung cancer published in the NEJM, but unfortunately the DOI code isn't yet available for easy tagging and linking of the article in Research Blogging, so it will have to wait until it's out.
There was, however, a pair of interesting articles on computerised tomography (CT) scans (see references and links below). While the use of such scans has clearly improved diagnosis, it has come at a cost – both in terms of expenditure and also with respect to increased risk of radiation exposure:
"We found that the risk of cancer from a single CT scan could be as high as 1 in 80 — unacceptably high, given the capacity to reduce these doses."
Source: Smith-Bindham, NEJM
"Changing the culture of medical practice to encourage more thoughtful use of imaging today will help to ensure that future patients will benefit from continued imaging innovation."
Source: Hillman and Goldsmith, NEJM
Good points both, but little is likely to change unless the payers and insurers force them economically. Physicians are typically cautious and conservative by nature and would rather check to see if any cancer might be present than risk missing it or be hit with a law suit for negligence. Given that radiation has not been shown conclusively to be cancer-causing, most would probably rather be safe than sorry.
Smith-Bindman, R. (2010). Is Computed Tomography Safe? New England Journal of Medicine DOI: 10.1056/NEJMp1002530
Hillman, B., & Goldsmith, J. (2010). The Uncritical Use of High-Tech Medical Imaging New England Journal of Medicine DOI: 10.1056/NEJMp1003173