Report attacks X-ray abuse

Press, 22 June 1983, Page 13

Report attacks X-ray abuse

By

JOHN MADELEY

X-rays are now so overused and misused that they have become a “major source” of exposure to man-made radiation, says a report to be published later this year by the World Health Organisation. The report, by a team of leading radiologists, says X-ray examinations are frequently useless, always expensive, and often carried out as a matter of routine without medical justification. Pregnant women are subjected to unnecessary X-rays which expose the unborn child to radiation. ! ‘Chest radiography taken during pregnancy,” says the report, “provides some radiation exposure to the embryo or foetus,” and all routine X-rays during pregnancy 'fiiould be regarded & “unjustified.” The group, led by Professor Erik

Boijsen of the Swedish University Hospital at Lund, criticises the fact that radiologists are often not consulted before X-rays are ordered. Doctors should take advice from radiologists, it recommends, on whether an X-ray might be useful. Studies cited in the report show that X-rays have proved to be “clinically non-productive” — that is, of no benefit to the patient — in all cases where a person had no symptoms of disease or where the illness could diagnosed in other ways.

Although routine chest X-rays are common they are said to serve no useful purpose in countries where there is little chest disease. Routine X-ray examination of teachers and schoolchildren is described as “very unproductive” except where there is evidence of tuberculosis or similar infections. Even for TB examinations, the report claims that,, in the absence of symptoms, reputed chest Xrays “have not been shown to be of

sufficient clinical value to justify their continued use.” For breast cancer examination, the report recommends that periodic X-rays should be restricted to those aged over 50. Under that age, regular screening is advised only if there is a personal or family history of breast cancer. There is no evidence that periodic X-rays lead to earlj-kletec-tion of lung cancer. For patients

suffering from hypertension and angina, clinical examination is said to be more beneficial than an Xray. X-rays are warranted, says the report, when there is a clinical indication of disease in a patient, “or when there is epidemiological evidence of a disease in an area or in a group of individuals.” The report is likely to be read with unusual interest by health ministries, especially those seeking cost savings without affecting patient care. X-ray are now so expensive they account

for between six per cent and 10 per cent of the health budgets of many countries. — Copyright, London Observer Service. © Professor R. A. Gibson, chairman of Radiology Services, North Canterbury Hospital Board, commenting on the above report, says: “Professor Erik Boijsen is well known to me and I have no doubt that the report will be authoritative. In general, I agree with the comments extracted from the report. “However, some of the criticisms of ‘routine X-rays’ are no longer valid in New Zealand. In my opinion, doctors do take advice from radiologists, who may modify the examination being requested after consultation with the referring clinician.”