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Diagnostic Imaging: Beam Me Up Dr. McCoy

We're not quite at the Star Trek level yet with imaging technology, but recent advances are fine-tuning your medical care.
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Using Imaging for Routine Screening -- the Pros and Cons

A topic that's spurred interest -- and debate -- is screening apparently healthy people for cancer, heart disease, and other problems. Sophisticated imaging tests can sometimes detect disease in very early stages, long before a person shows any other symptoms.

So given the obvious benefits, why isn't everyone in America being screened? It turns out that there are some real drawbacks to routine screening.

First of all, imaging has risks. Many tests involve exposure to small amounts of radiation or radioactive material. While the odds that this could cause harm are low, they still exist, says Eversman.

The other problem is that screening can detect abnormalities that don't actually need any treatment. But once the doctor sees them, further tests must be ordered to make sure that these abnormalities are harmless. So people may need a number of tests or even surgery -- and suffer a lot of anxiety - only to discover that they didn't need treatment!

"There are a lot of nonspecific abnormalities," says Hillman. "For instance, an enormous number of people have nodules in their chests. But only a fraction of them actually turn out to be cancer." Universal screening could lead to a lot of unnecessary and risky tests and procedures.

Even in apparently healthy people who really do have a disease, screening may not always help.

"Catching the disease early and stopping it would be great," says Hillman. "But lots of times, that doesn't happen. You find the disease earlier, you treat it earlier, but the outcome is the same and the person dies anyway." Early detection helps many people, of course. But it doesn't always make a difference. For those who aren't helped, it leads to tests, treatments, and intense distress much earlier than someone who wasn't screened.

Smarter Use of Imaging for Screening

As for now, no one recommends routine high-tech screening for everyone.

"The American College of Radiology does not endorse whole body screening of healthy people," says Eversman. "It probably shouldn't be done, since there's no proof that it saves lives or even improves them."

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