Peace of mind -- but at a price

FIT, tan and significantly younger-looking than his 57 years might suggest, Garret Leahey still worries about the perils of getting older. Is he really as healthy as he thinks? He's heard the horror stories, especially the guys who eat right, run every day and then have a heart attack during a jog in the park or while playing basketball with their kids. "I know things can change on a dime," he says flatly.

So two weeks ago, the Los Angeles man decided to do something about it: He got a full-body CT scan. Cost: $800, all out-of-pocket.

Since arriving on the scene just a few years ago, elective CT scans -- essentially powerful, computer-aided X-rays once reserved for sick or high-risk patients -- have exploded in popularity with throngs of worried well who need to know they are OK. The number of CT scans reached 32 million last year, up 6 million since 1997, with a significant chunk of that gain coming from elective tests.

"This is fast becoming an integral part of people's annual medical regimen," says Bruce Friedman, president of Heart Check America in Los Angeles, where Leahey underwent his procedure.

Still, many doctors and medical associations balk at the trend. The Food and Drug Administration, the American Cancer Society and the American College of Radiology recommend against the exams for patients without symptoms. Many physicians say self-referred screenings aren't worth the money, especially because most insurance companies won't pay for screenings on a preventive basis.

Many also fear that elective scan results are riddled with false positives that lead to needless anxiety and possibly dangerous follow-up procedures.

Scan proponents often paint critics as little more than scaremongers, pointing out that the scans can detect problems other exams may miss. But a small and growing body of research seems to support some of the critics' concerns.

Recent studies have shown that although more than a third of the people who get scanned find something abnormal enough to require a follow-up, as few as 1% ultimately discover anything meaningful. Other research validates different fears, such as high radiation exposure that in some cases can reach 250 times the level of a typical chest X-ray. Several states, including Texas and Pennsylvania, have passed laws banning patients from getting scans without a doctor's referral.