Approximately 93 million computed tomography (CT) examinations are performed on 62 million patients annually in the United States. CT scans expose patients to ionizing radiation at levels known to be associated with increased cancer risk. Several large retrospective cohort studies have shown that childhood exposure to CT is associated with increased risk of hematologic malignant neoplasms and brain cancer. There is also evidence that CT scans damage DNA in adults, with radiation-induced cancer risks from CT examinations varying by radiation dose, which depends on the clinical indication; body region imaged; patients’ sex, age, and size; and acquisition techniques. A 2009 analysis estimated that approximately 29, 000 future cancers would result from routine CT exposures in the United States in 2007.
The results of a new analysis published in JAMA Internal Medicine on April 14, 2025 entitled, “Projected Lifetime Cancer Risks From Current Computed Tomography Imaging” investigated the question of how many future cancers could result from radiation exposure from annual computed tomography (CT) examinations in the United States, and to project the number of future lifetime cancers in the US population associated with CT imaging in 2023.
The researchers reported: “An estimated 61 510 000 patients underwent 93 000 000 CT examinations in 2023, including 2 570 000 (4.2%) children, 58 940 000 (95.8%) adults, 32 600 000 (53.0%) female patients, and 28 910 000 (47.0%) male patients. Approximately 103 000 (90% UL, 96 400-109 500) radiation-induced cancers were projected to result from these examinations. Estimated radiation-induced cancer risks were higher in children and adolescents, yet higher CT utilization in adults accounted for most (93 000; 90% UL, 86 900-99 600 [91%]) radiation-induced cancers. The most common cancers were lung cancer (22 400 cases; 90% UL, 20 200-25 000 cases), colon cancer (8700 cases; 90% UL, 7800-9700 cases), leukemia (7900 cases; 90% UL, 6700-9500 cases), and bladder cancer (7100 cases, 90% UL, 6000-8500 cases) overall, while in female patients, breast was second most common (5700 cases; 90% UL, 5000-6500 cases). The largest number of cancers was projected to result from abdomen and pelvis CT in adults, reflecting 37 500 of 103 000 cancers (37%) and 30 million of 93 million CT examinations (32%), followed by chest CT (21 500 cancers [21%]; 20 million examinations [21%]). Estimates remained large over a variety of sensitivity analyses, which resulted in a range of 80 000 to 127 000 projected cancers across analyses.”
The study concluded: “CT examinations in 2023 were projected to result in approximately 103 000 future cancers over the course of the lifetime of exposed patients. If current practices persist, CT-associated cancer could eventually account for 5% of all new cancer diagnoses annually.”
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