Cancer patient focus groups reveal desire to know more about radiation risks

Patients have a limited understanding of how ionizing radiation is used in medical imaging and there is an opportunity for clinicians to step up and help educate their patients, according to a study published online March 24 in Radiology.

A series of focus groups conducted for the study revealed patients have a general awareness of the risks associated with ionizing radiation exposure and they are eager to learn more from their doctors about the specifics of these risks, which modalities use radiation, and why imaging procedures are ordered.

“Patients want this information, and they prefer to receive it from doctors they know and trust,” senior author Jennifer Hay, PhD, a behavioral scientist at Memorial Sloan Kettering Cancer Center in New York City, said in a press release.

The findings are based on more than nine hours of conversations with 30 patients who had undergone medical imaging. Five focus groups featured cancer patients and a sixth focus group featured participants from a lung cancer screening program.

While many participants were aware of the potential risk of future cancer from medical imaging, benefit-risk discussions were seldom initiated by clinicians, and most patients sought out information themselves online.

This self-directed education left a number of gaps. Hay and colleagues noted that even though many of the patients had undergone frequent exams, there was much uncertainty regarding which modalities used ionizing radiation. Some patients also confused radiation from diagnostic imaging with radiation therapy.

Focus group participants demonstrated a desire for the following information:

• Basic knowledge about which tests use ionizing radiation;
• How tests differ and how doses compare;
• The rationale behind specific test orders and testing intervals; and
• Why multiple tests are sometimes ordered.

Participants generally saw clear benefits from imaging and most said having conversations about the risks would likely not impact their decision to proceed with the procedure.

As one might expect, the desire to learn more about long-term risks of imaging-related radiation grew as cancer patients transitioned from the treatment phase to survivorship.

“A patient who has no interest in shared decision making about imaging tests during active cancer treatment may have a high degree of interest in information and decision-making autonomy as a cancer survivor,” wrote the authors.