Most parents underestimate CT risks for children

Public awareness about radiation exposure risks has swelled in recent years; however, more than half of surveyed parents remain unaware of potential increased risks for lifetime malignancy for children undergoing CT, according to a study to be published in the August issue of Pediatrics.

Once parents were informed of the potential risks, willingness to proceed with a CT was initially reduced. However, the vast majority of parents said that if a physician thought CT was necessary, knowledge of the risks would likely not affect the decision to go ahead with the exam, explained Kathy Boutis, MD, of the Hospital for Sick Children and University of Toronto, and colleagues.

“Although researchers are working to achieve more precise estimates of the malignancy risk, clinical practice continues, and it is therefore important that we gain an understanding of parental knowledge and perceptions of the potential risks of ionizing radiation from imaging procedures,” wrote the authors.

Boutis and colleagues conducted a prospective cross-sectional survey of parents whose children presented to a tertiary care pediatric emergency department with a head injury. Surveys were administered from September 2011 through August 2012, and a total of 742 parents’ responses were included in the final analysis.

Results showed that 46.8 percent of the respondents knew of the potential for an increased risk of lifetime malignancy from CT. Many underestimated the risks of CT, and guessed that the dose and risks of a skull radiograph was similar to that of CT, despite the fact that doses for CT are 60—80-fold higher. This pervasive misunderstanding may affect the extent to which parents initiate a conversation about potential risks.

“Clinicians may therefore have a greater responsibility to initiate conversations with families about the risks/benefits of CT rather than do so only when prompted by the patient,” wrote Boutis and colleagues.

An open conversation about the risks and benefits of the procedure appears to be just what the parents want, according to the study. More than 90 percent said they wished to be informed of malignancy risks, and while knowledge of risks induced some hesitancy, about 95 percent would choose to proceed if the scan was doctor-recommended—an important finding as the benefits of imaging often far outweigh the risks.

Open communication with parents is key as media attention to CT-related malignancy risks increases. The authors noted a 2006 study found only 13 percent of parents were aware of the risks.