Rising CT Scan Use in Older Adults Raises Radiation Exposure Concerns

The proportion of CT scans performed on patients aged 60-90 is increasing, raising concerns about cumulative radiation exposure in this vulnerable population. While CT scans are vital diagnostic tools, repeated exposure to the radiation they use can incrementally increase health risks.

The Growing Trend in CT Scan Utilization

A recent analysis at a single quaternary-care academic hospital revealed a significant shift in CT scan demographics. The percentage of scans performed on individuals between 60 and 90 years old rose from 50.4% in 2014 to 58.3% in 2024 [1]. This trend is particularly notable as younger adults have shown a decrease in repeated imaging over the same period, falling from 17.4% to 12.7% [2].

In 2024, 26.6% of patients aged 60 and over underwent two or more CT scans annually, a slight increase from 25.6% in 2014. A substantial portion of this age group experiences high-frequency use, with some undergoing five or more scans per year.

Why CT Scans Are Used and the Associated Risks

CT scans utilize X-rays to create detailed images of the body’s internal structures, making them essential for diagnosing a wide range of conditions, including fractures, cancers and cardiovascular diseases. However, CT scans do expose patients to ionizing radiation. While the risk from a single scan is generally low, cumulative exposure from multiple scans over time can potentially increase the risk of cancer [3].

How the Study Was Conducted

Researchers retrospectively analyzed all CT exams performed at the quaternary-care academic hospital between 2014 and 2024. Patients were categorized by age group, and researchers calculated annual CT volume and per-patient exam frequency. They specifically focused on identifying patients undergoing two or more, three or more, five or more, and ten or more exams per year [2]. The study projects that elderly patients could account for nearly two-thirds of all CT scans at this hospital by 2035.

Limitations and Future Considerations

It’s important to note that these findings are based on data from a single hospital and may not be representative of national or international trends. The study did not correlate imaging frequency with clinical outcomes, nor did it quantify individual radiation doses. The research does not establish a direct link between CT scan frequency and cancer development.

Implications for Clinical Practice

The increasing trend in CT scan utilization among older adults underscores the need for careful consideration of the benefits and risks of imaging. Clinicians should prioritize justified imaging, optimize scanning protocols to minimize radiation dose, and explore alternative imaging modalities when appropriate. A patient-centered approach that balances diagnostic accuracy with radiation safety is crucial as the elderly population continues to represent a larger proportion of CT scan recipients.

Key Takeaways

• CT scan utilization is increasing among older adults (ages 60-90).
• Repeated CT scans contribute to cumulative radiation exposure.
• While a single CT scan carries a low risk, multiple scans can increase potential health risks.
• Clinicians should carefully weigh the benefits and risks of CT scans, especially in older patients.

Reference: Pham G et al. Computed tomography utilization and radiation risk in the elderly: Let us not downplay frequent imaging. Br J Radiol. 2026;DOI:10.1093/bjr/tqag051.