Are Body Scans A Scam?

Dr. Craig Bittner wants to save your life, and he believes he has just the tool. In the time it takes to perform a traditional chest X-ray, any one of his four AmeriScan Body Imaging Centers can generate a high-resolution CT (computed tomography) scan that illuminates your whole inner torso, from neck to pelvis. True, it costs nearly $1,000, and few health plans will touch the bill. But unlike a mere chest X-ray, this test promises to spot "major killer diseases like stroke, aneurysms, cancer and lymphoma," not to mention gallstones, kidney stones and osteoporosis. "We save someone's life every day," Bittner says.

You've probably heard the pitch. CT scanning centers are cropping up like Starbucks in metropolitan areas, and consumers are responding. Dr. Harvey Eisenberg, the southern California radiologist who analyzed Oprah's innards on TV two years ago, has now put 30,000 people through his machines in Newport Beach. "Do you want to find out about [your life-threatening disease] when the surgeon is standing there with the knife?" he asks. "Or do you want to find it as early as you can?" Alas, the issue isn't quite that simple. So before you reach for your credit card, let's consider the merits.

No one denies that CT is a brilliant innovation. Unlike a standard X-ray machine, a CT scanner records the body's inner contours in thin, cross-sectional slices. The new "spiral scanners" that have flooded the market over the past year don't even have tomblike enclosures. You simply lie on a platform as it glides through an open ring. The cross-sectional snapshots can then be digitally recombined to create images of various tissues and organs. The machines were developed not as all-purpose screening instruments but as diagnostic tools. Used with the right software, a spiral CT scanner can show a cardiologist exactly where a patient's arteries are blocked. It can also perform "virtual colonoscopy" (not included in a "full body scan"), revealing polyps and tumors almost as reliably as an endoscope. And studies suggest that CT scans are better than regular X-rays for spotting nascent tumors on smokers' lungs.

But it's one thing to test a high-risk patient for a particular problem--quite another to screen healthy people at random, viewing any blemish on any organ as a possible cause for concern. The radiation from a full-body CT scan isn't likely to harm you, but it's 500 times the amount you'd get from a chest X-ray. Some centers are now pursuing MRI scanning (which doesn't involve radiation) as an alternative. Still, high-resolution images are of limited use when you don't know what you're looking for. Is that spot on your lung a malignancy? Chances are it's nothing, but once visible it's hard to ignore. As the American College of Radiology warned last summer, many of the findings "will not ultimately affect patients' health but will result in increased... anxiety, unnecessary follow-up examinations and treatments, and wasted expense."

How do the boosters respond? Not with data (no one has published any), but with testimonials from people like Jerry Pettitz, a Seattle probation officer who visited AmeriScan in Scottsdale, Ariz., in 2000 and discovered a 10-pound tumor on his kidney. It's gone now (along with the kidney), and Pettitz counts himself lucky. "It's empowering," he says. "Without the scan, I would have had to wait until I had symptoms."

Fair enough. But few of us are walking around with life-threatening masses on our organs. "Discovering a kidney cancer in a young man is a one-in-a-quarter-million possibility," says epidemiologist Robert Smith of the American Cancer Society. Neither the Cancer Society nor the American Heart Association endorses full-body CT screening. Neither does the Food and Drug Administration, the American College of Radiology or the Radiological Society of North America. Even some of the marketers are having second thoughts. Marc Manuel, vice president and co-owner of Imaging for Life in New York, says he's moving away from the whole-body business in favor of virtual colonoscopy and CT angiography. If you don't need one of those tests, save your money. Or better yet, invest it in a gym membership.