Are CAT Scans Killing Patients?
ANDERSON COOPER, CNN ANCHOR: Tonight: a common medical test that's a lot more dangerous than you think. Researchers now believe C.T. scans could actually be killing thousands of Americans, delivering too much radiation, and causing deadly cancers. We will up close with 360 M.D. Sanjay Gupta tonight. Also ahead, "Raw Politics": Senator Joe Lieberman has almost single-handedly forced Senate Democrats to scrap their hard-won compromise on one of their key components of health care reform. So, how did he do it? And is he really the most hated man in Washington tonight? And later, in "The Shot," Larry King takes us behind the scenes of his interview with the cast of "Nine" today, just Larry in a room full of beautiful women,. He will tell us what went on during the commercial breaks. First up: the medical tests you may have had and the hidden risks you might have been exposed to. We're talking about C.T. scans. Now, they're used to take images everything from your heart to your head to your pelvis. Doctors and patients like them because they're -- they're noninvasive, they're fast, and they're painless. But, tonight, there are serious questions being raised about their safety. Come over here. Take a look at this wall. Now, this -- well, this is what a C.T. scan looks like. This is actually a C.T. scan of my heart. I had it done in 2004 for a story that we were doing on heart disease. It runs in my family on my dad's side. Now, when you look, when you get a scan like this done, you know you are going to be exposed to radiation, right? And it has long been thought that the ordinary chest C.T. scan would deliver about the same amount of radiation as 100 X-rays. But now researchers found that the radiation doses delivered by C.T. scanners actually varies widely, even within the same hospital with the same types of scans. Take a look at this. C.T. scans actually can be equal to about 440 times conventional X-rays, instead of just 100. Now, use of C.T. scans have -- have tripled since the '90s. They may be getting overused, in fact, and, according to this -- this study, in 2007, about 72 million C.T. scans were performed in the U.S. So, researchers wondered how much cancer all of these scans in just one year could be causing? And that's where this gets really scary. Take a look. They calculated that 29,000 future cancers could result from all those scans done just in that one year, done in 2007. And they estimate that these 29,000 cancers are going to appear in the next two to three decades, causing nearly 15,000 deaths. For women and young patients, the risks are greatest, and they are -- also vary by type of scan. For instance, for heart scans, which typically use the highest dose of radiation, researchers calculate about one in 270 women who receive a heart scan at age 40 will develop cancer as a result. For men, it's about one in 600. Now, as someone who has had a couple of these now over the years, this is scary stuff. Sanjay Gupta has also had a bunch. This is actually a C.T. scan of Sanjay's heart done back in 2004. I talked to Sanjay earlier today about these new studies.</s>COOPER: What's the headline from this? I mean, this seems incredibly alarming when you first look at it.</s>DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: I think it is. And I think, again, it is worth pointing out, I have probably, over the day today, gotten 40 e-mails and talked to several people who say, you know, a reminder that this again is projected numbers. This is based on modeling. And no one is saying tonight that anybody who has had CAT scans for sure is going to get cancer. This is somewhat theoretical</s>COOPER: Well, what does that mean, though, that this -- what does this mean, that it is theoretical, that it is based on modeling?</s>GUPTA: Well, you look at the amount of radiation being given off by these machines. And, in this case, they actually compared it to the radiation doses that they saw during the atomic bomb, during Hiroshima and Nagasaki, and tried to actually extrapolate the amount of radiation they saw there, cancer rates they saw, and tried to model that will on C.T. scans and the radiation being given today. The American College of Radiology will point out, look, hang on. That was a much less controlled situation. We control C.T. scanners a lot more.</s>COOPER: But it is certainly cause for center. And if you're going to have a C.T. scan done of any kind, it is important to make sure that it is essential that it's -- that it's -- that the procedure is done, that it's not just some sort of added thing that's tacked.</s>GUPTA: There was a big thing about full-body C.T. scans a few years back. I think you and I talked about that, people just getting these C.T. scans just to see if there is anything going. That's probably not a good idea.</s>COOPER: Sanjay, we got those CAT scans done back in 2007. Knowing what you now know, would you have chosen another kind of tool, besides the CAT scan?</s>GUPTA: Well, you know, it's worth pointing out that there are risks and benefits with everything. And that is particularly true in medicine. You and I both had these -- these tests done. I have a pretty strong family history of heart disease on my father's side of the family. And, Anderson, I think do you, as well, right?</s>COOPER: Right. Yes, definitely.</s>GUPTA: With me, there was a series of tests ahead of time they -- that they do before getting to a test like a C.T. angiogram, and trying to figure out if I have risk factors. But, in my case, they -- you know, the doctors deemed that it was a good screening test to have. But, you know, Anderson, you probably know this. About a third of CAT scans that are done right now, this particular study says, may be unnecessary. And there are a lot of other tests out there potentially that could also serve the purpose. But, you know, as we talk about this, and the thing that's important to say that the American College of Radiology and other organizations don't completely accept all these findings and all these increased cancer risks. And, to be fair, there has not been a documented case of a C.T. scan subsequently leading to cancer.</s>COOPER: Well, what is somebody supposed to do? You and I both have a family history of heart disease on our dad's side. What is the alternative to getting one of these C.T. scans?</s>GUPTA: Well, you know, there -- there are tests -- for example, someone is having symptoms of some sort, shortness of breath or chest pain or something like, most likely, they are going to get tests that are not quite like this one first, a stress test, for example. Someone runs on a treadmill. They may get an echocardiogram, where they're actually doing sort of ultrasound to the heart. The gold standard test, incidentally, Anderson, is a -- is an angiogram, which I know you have heard of as well. But that involves actually putting a catheter near the heart and injecting dye and taking pictures there. It may has less radiation, but that also carries a set of risks. So, like I said, you know, you know, it really comes back to a risk- benefit analysis of all these things. Do you risk the extra -- the extra radiation vs. getting an angiogram and the risk of potentially having a stroke or something like that, which that can sometimes cause?</s>COOPER: And, I mean, we saw how the levels of radiation can vary depending on the technician who is actually giving the dose. Is there an acceptable level of radiation?</s>GUPTA: Yes, I thought that was amazing. I mean, the same exact procedure, same hospital, two different machines, and you can get up to 13 times the difference in radiation doses. As far as acceptable levels, it really depends on the type of procedure being performed. So, the -- the test that we're talking about that you and I had, they talk about 22 units of radiation. Now, that doesn't mean anything to a lot of people. For -- but, for an abdominal CAT scan, for example, it's typically around 30 units of radiation. But, again, in some hospitals, you can have one machine that does 30 units of radiation and one that does 90, 120, much more. So, there is very little regulation at least even within the hospitals themselves.</s>COOPER: So, is there a way that a patient can find out what the acceptable level of radiation is before the procedure, for a particular procedure?</s>GUPTA: I think most of this has been sort of internally regulated within the industry. So, I think this is -- this is a little bit of a surprise to many people to hear tonight that there can be such wild variations. So, there's really two things. One is that they have to sort of lower the amount of radiation being given off by these machines in general. That is just be an improvement of the technology. But, to your point, try and reduce the variations, so patients don't have to ask about this.</s>COOPER: We talked how women are more at risk. Who else is at risk, and why these particular groups?</s>GUPTA: Yes. You know, so, women more at risk, probably because, frankly, they're usually more diligent about health care and, as a result, get more screening tests, including tests like this one. But -- but, interestingly, it was really people around the ages of 35 to 54 who seemed to be the most at risk, again, according to this modeling. And that's really probably because that's the time that people are starting to get screening tests. It's also the time where people start -- may notice things. You know, if they have had some problems that have been longstanding, they may start to notice it around that age group as well. So, 35 to 54 seems to be the -- the -- the highest target area.</s>COOPER: All right. Good advice. Sanjay, thanks.</s>GUPTA: Thanks, Anderson.</s>COOPER: Well, you can find out more facts about C.T. scans on our Web site at AC360.com. That's where you can also join the live chat now under way. AC360.com is the address. In a moment: Joe Lieberman, possibly the most hated guy on Capitol Hill tonight, at least among Senate Democrats, how he ended up calling so many shot in the health care debate, and what happens next to that Senate bill. And later, remember all the talk by President Obama about cutting earmarks, the pork spending or congresspeople just love? Well, there is another massive pork-filled spending bill, $447 billion that includes billion in earmarks. There's nearly a million dollars for a shrimp. Sound like money well spent? It's your money. That's just the beginning. We're "Keeping Them Honest" tonight.