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Eight Key Points:
Your Stake in the Patients' Right-to-Know about X-Rays

By John W. Gofman, M.D., Ph.D.
December 2000

XaHP: The X-rays and Health Project.
      An educational project of the
      Committee for Nuclear Responsibility.

The plan:  Lower x-ray doses per x-ray procedure.
The result:  Fewer cases of x-ray-induced cancer
and coronary heart disease.

        1  o  X-rays are a proven cause of human cancer. It is doubtful that you can find any cancer biologists who would deny that statement. Much of the proof comes from the study of people who accumulated their x-ray exposure from multiple exposures, with each exposure received at extremely low doses. Every year, over 200 million diagnostic medical x-ray exams, 100 million dental x-ray exams, and 7 million diagnostic radionuclide exams are administered in the USA (population: 270 million people).

        2  o  In the "War on Cancer," there is a big hole. Why are x-rays --- an undisputed cause of cancer --- rarely mentioned? Why is there no agency or organization dedicated to reducing exposure to x-rays, to the lowest levels at which it is technically possible to acquire good images? It is demonstrably feasible to reduce x-ray dose per x-ray procedure, probably to half on the average, without any loss of image-quality and without the purchase of major new equipment.

        3  o  My recent study (Radiation from Medical Procedures, 699 pages) provides the first powerful evidence that the U.S. population's accumulated exposure to medical x-rays is a necessary co-actor in causing over half the deaths from cancer, and over half the deaths also from ischemic (coronary) heart disease. Since the study's publication in November 1999, no one has shown that it overestimates the impact of x-rays in causing cancer and coronary heart disease. Some people say "it must be an overestimate," but they have never shown how. Some of the critics have never even looked at the study.

        4  o  If the exact size of the x-ray's impact is uncertain, what is the responsible action? Suppose that my analysis overestimates the impact. Then reducing x-ray dosage per x-ray procedure would still be guaranteed to prevent innumerable cases of these diseases --- just somewhat fewer cases than my analysis indicates. By contrast, taking no extra steps to reduce x-ray dosage would be guaranteed to do a lot of harm, by not preventing preventable cases. Neglecting a guaranteed and 100% safe way to prevent cases is morally equivalent to causing the cases which could have been prevented.

        5  o  In short, a policy of "Doses Down Now" can do only good, whereas failure to act on that policy can do only harm.

        6  o  So a key question is: If experts appear to disagree about the importance of x-rays, do you prefer a prudent policy or a reckless policy?

        7  o  A prudent policy would start with every major x-ray practitioner inviting regular consultations with a team of experts in dose-reduction. These medical physicists would teach how to measure x-ray dosage and how to use already-demonstrated ways to reduce doses with the practice's existing equipment.

        8  o  The right time to start action on the "Doses Down Now" policy is today, because achievements in your locality can benefit your family and your community within 18-24 months, without waiting for statewide or nationwide success. Any locality can get its x-ray doses down, regardless of how slowly other regions might make progress. The "Doses Down Now" policy is a proven way to prevent some of the cancer problem, not a "maybe."

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