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Before ordering a scan, screen these factors first

September 01, 2003|Daniel Costello | Special to The Times

Although no major medical association recommends elective CT scans and research increasingly points to its risks, the reality is that many people still see them as a way to make sure their health is fine. Here's a list of things to consider before having a test done:

Assess your risk. Most proponents of self-referred CT screens recommend that only high-risk patients, such as former or current smokers or those with a family history of heart diseases, get the scan. A recent New England Journal of Medicine article suggested heart scans may be beneficial for high-risk men over 35 and high-risk women over 40.

Consider whether you really need the full-body scan. Although many doctors remain unconvinced by research supporting the benefits of any elective scan, most agree there's almost no good research outside scans of the lung and heart.

Research the technology. There are two basic types of body scans, the traditional CT scan and the newer EBT scan. If you are looking for a heart scan, the EBT is better. It's faster, which makes for clearer images of the beating heart, and gives off less radiation. Traditional scanners are better for things like lung scans.

Also, make sure to inquire about how many detectors, or "cameras," the CT scanner has. If they have less than four, the pictures will be nearly useless.

Check with your insurance company first. Most insurance companies refuse to pay for preventive screenings, but a few do.

Also, certain unions and some professional associations, such as the Los Angeles County Sheriff's Department, are starting to pick up part of the tab. Some insurance companies will pay for follow-up scans if the first one found something that your doctor wants to keep an eye on.

Don't skip your annual checkup. Doctors worry that some people who get "a clean bill of health" from a scan may try skipping annual exams. Don't, they say.

When it comes to general health issues, CT scans miss more than they catch.

Don't go more than once a year. Considering the level of radiation exposure (up to 250 times that of a normal chest X-ray), radiologists recommend no more than one screen a year. That's especially true for young people and women of childbearing age.

Radiation exposure is cumulative over a lifetime, and it's still not completely clear what effects it has on many organs or other areas of the body such as breast tissue.

Change your lifestyle. No matter what scans show, doctors say the No. 1 way to prevent disease is to change your lifestyle. Top suggestions: Quit smoking, watch your diet, exercise.

Shop around. As more and more centers open around the country, prices are falling. Most full-body scans are about $1,000; specific exams like heart and lung checks cost about $400 or $500 each.

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