Introduction
If you have no symptoms of disease but are considering getting a whole-body CT screening exam, you may be thinking either or both of the following:
a. "For my peace of mind, I purely want to know that I don't have any diseases in a minute."
b. "If I have a disease, I want to know in the order of it now so that I can do something just about it."
What you may not realize is that getting a whole-body CT screening exam may not accomplish either of these goal. In particular, an extraordinary finding may not be a serious finding at all. And a ordinary finding may be inaccurate. We will consider these one at a time below, but up to that time we do, the good communication is that, if you have no symptoms of malady, the probability is high that nearby is nothing seriously wrong next to you--and this is true without your ever getting a whole-body CT screening exam.
Should you be screen? Like any other medical procedure, there are risks involved. Before undergo this exam, be sure to read all the section of this web site. Consider further that the FDA have never approved CT for screening any part of the body for any specific disease, agree to alone for screening the whole body when in that are no specific symptoms of disease at all. No factory owner has submitted background to FDA to support the safety and efficacy of screening claims for whole-body CT screening.
What is a screening exam?
A screening exam is a medical exam to be precise performed on individuals who are at risk for a singular disease or condition, but who lack any signs or symptoms of the disease or condition, to determine if the disease or condition is present. Common examples of screening procedures are:
* mammography for breast cancer in women over 40 years of age
* Pap smear for cervical cancer in women over 18 or sexually active
* colonoscopy for colon cancer in men and women over 50
* blood pressure width for hypertension in anyone
* measure blood sugar for diabetes in anyone.
As the examples illustrate, screening exams are across the world done to look for a particular disease or condition, and they should largely be done only when clinical studies hold demonstrated that screening exams may do more good than damage.
Is CT the best way to eyeshade for any disease or condition?
At this time, no--although there are currently surrounded by process trials to determine if:
1. spiral CT might be a useful method to eyeshade for lung cancer in smokers of dedicated ages,
2. CT virtual colonoscopy is as good as colonoscopy surrounded by men and women over 50 and
3. CT coronary calcium scoring is effective contained by predicting heart disease.
Some diseases that do have forceful treatments can be found early satisfactory with test other than CT. For example, though this have again become controversial, screening mammography has be shown to find breast cancer early ample in masses cases to be curable, but CT has not be found to have such skill. Similar results have be found for Pap smears for cervical cancer, and colonoscopy for colon cancer. There are also diseases and conditions, other than cancer, for which hasty treatment, even if the disease were identified, would be no more significant than when treated later, at smallest with treatments currently available. And within are significant diseases that cannot be seen on CT, such as diabetes and hypertension.
When is screening beneficial?
Screening test can be extremely beneficial, but only beneath the following conditions:
* when the test is for a out of the ordinary disease or condition, rather than for a short time ago anything that can be found
* when the test is for a disease or condition to be precise curable or manageable if found precipitate enough but life-threatening by the time symptoms arise,
* when the try-out can find that disease or condition early satisfactory to be curable or manageable,
* when the question paper doesn't reveal too many findings that resemble the disease or condition but which in actuality would not hurt you,
* when the test doesn't miss too various cases of the disease or condition,
* when the test itself doesn't wound you significantly, and
* when the treatment for the disease or condition doesn't cause more mar than the disease or condition itself.
As mentioned above, examples of such screening tests are mammography, Pap smears, colonoscopy, and blood pressure width. Although there are ongoing clinical studies of CT to see if near is more benefit than harm for some diseases and conditions, at this time, at hand is no disease for which CT has be shown to satisfy the preceding conditions.
When is CT beneficial?
CT can be extremely beneficial when a soul has signs or symptoms of some precise disease or condition. CT can help to diagnose or rule out the disease or condition. Furthermore, within someone diagnosed with some exceptional disease or condition, CT can be extremely helpful surrounded by determining the extent of disease and in monitoring the effects of treatment. Such diagnostic use of CT in people near signs or symptoms differs from the use of CT in screening of race with no signs or symptoms. People next to symptoms have a much highly developed probability of having the disease or condition than relations without symptoms. Also, society with symptoms probably enjoy more advanced disease than someone without symptoms, which make it easier to find the disease on CT. The result is that in a group of people beside signs or symptoms, the probability of a true finding of actual disease is much higher, while the probability of a finding of something safe that is mistaken for disease is much lower.
What are the risks and benefits of whole-body CT screening?
Many population believe incorrectly that a medical test other distinguishes between the abnormal and the usual, or the sick and the well, or the diseased and the non-diseased. Every try-out does this only contained by some cases, and you can rely on the fact that every oral exam, including CT, gives incorrect results a definite portion of the time.
To understand the risks and benefits of whole-body CT screening, it is possibly easiest to divide the results of the exam into two possible outcomes, normal and peculiar.
If your CT examination result is interpreted as mundane, either
* you may really have nil significant wrong with you, or
* you may enjoy a hidden disease that fail to show up on a CT image or is missed or misinterpreted by the radiologist.
If your CT nouns result is interpreted as abnormal, either
* the exceptional interpretation may be incorrect or you may have nil significant wrong with you, or
* you may really enjoy a life-threatening disease for which there may or may not be a cure and, if a cure exists, at hand may or may not be time to do something that can cure it.
Consider these possibilities one at a time. If you receive a normal report and in attendance really is nothing significant wrong beside you, then you might walk away with peace of mind, but you will own exposed yourself to radiation and its associated risks. The radiation dose, in vocabulary of effective dose, from a CT exam can be several hundred times that of a chest x beam. Not only might this amount of radiation exposure hand over you a slightly increased chance of getting cancer, but also, if big numbers of healthy relatives now start to receive radiation exposure from whole-body CT screening for questionable benefit, the overall effect on public robustness could be detrimental. This would be detrimental all the more so if folks were to receive this nouns repeatedly, on a regular basis.
If you receive a run of the mill report but a life-threatening disease is really present, then you will own received false reassurance that could interfere with your recognize symptoms or getting appropriate screening tests latter. In addition, you will hold exposed yourself to radiation from which you derived no benefit.
If your CT screening result is interpreted as abnormal and within really is nothing significant wrong near you, then you may be subjected to still further test or treatments, all of which enjoy their own risks. For example, further tests may bring just about additional radiation exposure and the small randomness of toxicity from contrast material needed for visualization, or the bleeding, infection, and potential disfigurement associated near biopsy or exploratory surgery. And treatments may include surgery, radiation, chemotherapy, or medicines, respectively with its own small risks of injury, toxicity, or even departure. The surprising fact nearly a CT interpretation of abnormality when there is nil significant wrong is that it is far more likely to appear to you than the finding of any actual life-threatening disease, since the likelihood that you certainly have any incurable disease is so small to begin near.
Finally, if your CT is interpreted as abnormal and the abnormality represents an actual invisible, life-threatening disease, then you may own benefited. The benefit will be real individual if:
* the disease has an significant treatment, and
* it is found early ample for you to benefit from this treatment.
Many life-threatening diseases do not have impressive treatments, or, if they do, the period within which the treatment might have worked may enjoy passed already.
In summary, when possible risks are compared to the possible benefits, the harms currently appear to be both far more likely and within some cases may not be insignificant. These harms are: (1) radiation exposure which has a small risk of cancer induction for an individual CT procedure, and (2) the possibility of any a false finding of an abnormality or a true finding of an insignificant abnormality, either of which could front to further harm.
So, if you are apparently fine, the good communication is that the probability is already high that here is nothing seriously wrong beside you, without you ever getting a whole-body CT screening exam.
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