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Dr. Sanjay Gupta: Are full body scans worth the cost and risks?

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Dr. Sanjay Gupta  

Dr. Sanjay Gupta is a CNN medical reporter based at CNN headquarters in Atlanta, Ga.

CNN Moderator: Good day, Dr. Gupta. Welcome to CNN.com Newsroom.

Dr. Sanjay Gupta: Hello, everybody! Thanks for joining in!

CNN Moderator: What is a full body scan and why is it in the news?

Dr. Sanjay Gupta: A full body scan scans several different parts of the body, including the chest and the abdomen. Most full body scans at this time do not include the brain. It's been in the news a lot because several companies around the country have started to create mobile CT (Computerized Tomography) units, specifically a large truck, perhaps an 18-wheeler, goes into several cities around the country, and offers CT scans in your own neighborhood. Several people have found either heart disease or cancers, and have told their stories to the news.

Question from chat room: Do these companies weigh the benefits versus the risks of the radiation -- or is it just a money maker as it appears?

Dr. Sanjay Gupta: Each company does have a medical director, and there are several studies to actually assess the public health benefit, versus the risk. At this time, they do not recommend scans in men under the age of 45, or in post-menopausal women under the age of 50. But your point is well taken. There is not conclusive evidence showing that these CT scans offer any significant public health benefit, nor are they shown to be cost-effective.

Question from chat room: If a full body scan is recommended by a doctor, would insurance cover the cost?

Dr. Sanjay Gupta: In most cases, if there is an existing condition which warrants a CT scan, such as cancer, then most insurance companies and health-care providers do cover it.

Question from chat room: Dr. Gupta, by body scan... are you talking about internal imagery, or exterior topography?

Dr. Sanjay Gupta: CT scans rely on radiation technology to obtain internal imagery, or actual pictures of the organs.

Question from chat room: Does the seeming popularity of these scans say anything about our present healthcare systems in terms of people not feeling they are getting adequate treatment and attention?

Dr. Sanjay Gupta: Terrific question. There are many who think the full body CT scanners are classist, in that these scans are really only available to those who can afford them. It is difficult to say whether or not the general public sentiment is that our health care system is simply inadequate. It's a good point, and I'm not sure anyone knows the answer to that.

Question from chat room: What is the risk in scanning the brain?

Dr. Sanjay Gupta: The risk of a single CT scan to the brain is relatively small. The reason that most centers aren't scanning the brain is because a board-certified neuro-radiologist would be required to interpret those scans, in addition to a board certified radiologist.

Question from chat room: Dr. Gupta, are these essentially the same CT scans the medical profession has used for decades ?

Dr. Sanjay Gupta: Some of the technology has changed, some of the imaging characteristics are somewhat better in some areas. For the most part, the mechanics and physics of the CT scanner are similar to the CT scans everyone is more acquainted with.

Question from chat room: Hello Dr. Gupta, This is your brother Suneel...I would like to know if there are any harmful radioactive waves that affect a person in the long run with the full body scan?

Dr. Sanjay Gupta: Hi Suneel! The risk of a full body CT scan in terms of radiation is very small. Some have equated it to a transcontinental flight in a Boeing 747. The problem with radiation arises in kids who are still developing, or in people who need numerous scans over a short period of time.

Question from chat room: How much do these scans cost?

Dr. Sanjay Gupta: There are several different companies; the average cost is around $500.

Question from chat room: Doctor, could you elaborate more on the benefits of a fill body scan?

Dr. Sanjay Gupta: The benefits have been cited as picking up disease at a very early stage. It could be heart blood vessel calcifications, or could even be early tumors, as was the case of Jerry Seneker, who was on the show today. Jerry had a grade three cancer found in his kidney, but never had any symptoms. This was a potentially invasive cancer that could have greatly limited his life.

CNN Moderator: Could insurance companies eventually see this as a preventative measure that could save them money in the long run?

Dr. Sanjay Gupta: There's going to be significant research on that very issue. The issue is similar to the mammogram debate ten years ago. At that time, public health experts didn't know how often women should be screened and at what age the screening should start. Ultimately based on medical and economic reasons, it was found to be advantageous to recommend mammograms to all women at the age of 35 and on. Once the debate over the economic advantages of CT scans have been resolved, they may also be used as a screening tool.

Question from chat room: Dr. Gupta, what does the entire process entail with respect to time and preparation?

Dr. Sanjay Gupta: We talked to several people who went through the entire process. It was described that after a phone call was made, you were scheduled within a week or two. The CT scan itself took less than an hour. The results were mailed within two or three weeks. It is completely non-invasive. If there was an abnormal result, the results usually come faster, within two weeks, rather than three.

Question from chat room: In most cases couldn't an MRI be done and eliminate the need for the ionizing radiation?

Dr. Sanjay Gupta: Yes. However, the cost of MRI is even more prohibative that that of CT scanners. At this time, it's also very difficult to create mobile MRI scanners, as they are completely dependent on large magnets, which are difficult to transport.

Question from chat room: Dr. Gupta, How far are we from doing a scan at say 21 and doing repeated scans every five years or so to see signs of symptoms or abnormalities?

Dr. Sanjay Gupta: Mass screening tools will most likely become the way of the future as we move towards a healthier society that focuses more on preventative care. For CT scans to become that tool, they will likely have to come down in price, be more widely available, and show their advantages at a public health level. We're not there yet.

CNN Moderator: Do you have any final thoughts for us today?

Dr. Sanjay Gupta: The debate will continue to rage over the allocation of health care resources. At this time, insurance companies remain reluctant to pay for CT scans in healthy people. Their argument is that the costs are too high, and the chance of finding something too small. Doctors also argue that obtaining these CT scans, you may find abnormalities in your body that are of no significance, creating unnecessary anxiety. So be careful. Make sure to follow up with your doctor, and don't use a CT scan in lieu of regular health care screenings and physical exams.

CNN Moderator: Thank you for joining us today, Dr. Gupta.

Dr. Sanjay Gupta: Thank you very much! I enjoyed being here!

Dr. Gupta joined the chat via telephone from CNN Center in Atlanta. CNN provided a typist for him. The above is an edited transcript of the interview on Friday, June 01, 2001.



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RELATED SITES:
The American College of Radiology
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