As a Radiologist and Senior Medical Director at Care to Care, I find it my moral responsibility and professional obligation to explain the importance of a prior-authorization requirement for advanced imaging, and specifically CT examinations, for the pediatric population. Children are considerably more sensitive to radiation exposure than adults, as demonstrated by epidemiologic studies of exposed populations.
Since children have a longer life expectancy than adults, they have a larger window of opportunity for expressing radiation damage, most notably the development of cancer. As a result, the risk for developing a radiation-related cancer can be several times higher for a young child compared with an adult exposed to an identical CT scan.
A study published in the Lancet on June 7, 2012 described a clear dose-response relationship for both brain tumors and leukemia. The study found that the amount of radiation exposure from an estimated 2 to 3 head CT scans given to a child can triple the risk of brain cancer, and an estimated 5 to 10 head scans can triple the risk of leukemia.
Major national and international organizations responsible for evaluating radiation risks agree that no amount of radiation should be considered absolutely safe and that only necessary CT examinations should be performed. For these reasons, it is of utmost importance to make sure that only appropriate CT scans are being performed on children. A prior-authorization requirement will help ensure the appropriate use of CT imaging and limit its inherent harmful radiation.
Rachel Title, MD
Chief Medical Officer