Mobile CAT scans come to area with questions

MEDICINE VAN

ON THE NET:

www.cat-scan2000.com

www.fda.gov

By Scott Moyers ~ Southeast Missourian

A new mobile CAT scan unit that will visit Cape Girardeau and Jackson this week is being hyped by its Florida-based owners as a new technology that could save lives by finding abnormalities before they result in cancer.

But some prominent government and medical groups are warning that such tests may be fruitless, costly and could cause more health harm than good.

A company called CATscan 2000 is responsible for sending the mobile unit to the area. On Tuesday it will be the Jackson Church of Christ, and on Wednesday in Cape Girardeau at the Bethel Assembly of God church. The service requires appointments, which are made by phone.

CATscan 2000, of Clearwater, Fla., which calls itself the nation's largest mobile CAT screening service, offers full-body scans for lung cancer, coronary artery calcification and abdominal and pelvic disease. It has been visiting Missouri cities since May and offers similar services in 19 other states.

The executive vice president for the company, Joe McCarty, said the scans offer a beneficial early warning system. When there's early detection, he said, more time is available for treatment and recovery.

"If you had a tumor in your lung, wouldn't you want to know about it?" McCarty said. "These tests show that there's something there that needs to be looked at and should be followed. It's just to offer peace of mind. And of course there's controversy, it's new."

FDA opposition

The controversy stems from the Food and Drug Administration and the American College of Radiology, groups which oppose using CAT scans for preventive screening. They do so for several reasons, representatives say: It preys on people's fears who aren't in medical danger, causes needless stress and might be a serious health risk.

"For a person without any symptoms, CAT scan screening is really unlikely to discover any serious disease," said Sharon Snider, an FDA spokeswoman. "The potential harm to people may be greater than any presumed benefit."

CAT scans -- computed axial tomography -- use X-rays and computer techniques to take cross-sectional pictures of the body that can be viewed from any angle. Snider said that one CAT scan is about the same as 400 or 500 chest X-rays in terms of radiation exposure.

While a single chest X-ray carries a one-in-a-million cancer risk, the odds drop to one in several thousand with a full-body scan. She also said that preventive screening may cause unnecessary worry. Just because the tests find something doesn't mean it's life threatening or even a problem, she said.

Health insurance also doesn't cover such scans, meaning that it can be a drain on the pocketbook. CATscan 2000 procedures cost $199 each, but there's a discount for three.

Snider said that many people can get false positive results, leading them to seek additional and possibly risky tests and additional procedures.

Others had more harsh criticisms.

"Groups like that are strictly an entrepreneurial group, in it to make money," said Tom Welch, the manager of the radiology department at Southeast Missouri Hospital. "But it's not advisable to do that. Both hospitals here could do it, but we don't because it's not needed."

Eric Banda, director of radiology at St. Francis Medical Center, said scanning healthy consumers can result in unnecessary anxiety and expense.

"If patients feel they need a CT scan, they should speak to their family physician," he said. "Credible organizations such as the American College of Radiology are opposed to unnecessary diagnostic testing."

Welch echoed similar concerns that were cited by the FDA.

"You could walk up to the trailer, get a total body scan as long as you have the cash," he said. "We don't do it here because we're too busy taking care of real patients who are really sick."

McCarty said the criticisms are unwarranted.

"The same arguments were made about mammography screening," he said. "Everyone was saying that all it was going to do was scare women. Now every woman gets that done."

Risk factors

McCarty said much of the criticism is based on the premise that they offer mass screenings. He said that is simply not the case. He said his company screens people to make sure there are enough risk factors to warrant a scan.

For example, to undergo a heart scan, men must be at least 40 years old. Doctors also look for at least one of the following risk factors: Diabetes, overweight, physically inactive or a smoker.

"Doctors don't agree with widespread screenings, but that's not what we do," McCarty said. "We have limits. People have to have risk factors before getting scanned. If their parents lived into their 90s, never smoked a cigarette and they don't smoke, they're probably not at risk. We don't screen those people."

Between 6 and 7 percent of the people scanned have "severe findings," McCarty said. These call for immediate follow-up with a doctor.

But he pointed out that symptoms of disease often come too late. He said that each year, 150,000 men and women in the United States drop dead of heart attacks with absolutely no symptom of heart disease. Survival rates are dismal, he said, with late detection.

"I'd rather catch it early before it becomes a problem," he said. "There's nothing wrong with being cautious. We're not some fly-by-night operation."

smoyers@semissourian.com

335-6611, extension 137