Ads for body-imaging health screens may mislead

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Many newspaper ads and brochures touting high-tech body imaging to screen for cancer and other ills may mislead consumers about the technology’s benefits and risks, according to the results of a study released Monday.

Experts say the findings suggest a need for tighter government oversight of the ads, which promote whole-body computed tomography (CT) and magnetic resonance imaging (MRI) for screening symptom-free, apparently healthy people for early signs of cancer, heart disease and other medical conditions.

Clinics offering the services have sprung up in the U.S. in recent years, and people who have the cash to pay for the procedures, which cost anywhere from $400 to $1,200, can get them without a doctor’s referral.

However, while the procedures are approved for use as diagnostic tools for certain patients with symptoms, clinical trials have not yet established that they are effective for screening healthy people.

Centers that offer scans for screening take advantage of the fact that once the Food and Drug Administration (FDA) approves a drug or device for a specific use, doctors may also use them in other ways they deem appropriate.

Dr. Judy Illes of Stanford University, the lead author of the new study, said she and her colleagues “don’t by any means want to discourage people from following their doctors’ advice on screening.”

The concern, she told Reuters Health, is that people who seek MRI or whole-body CT scans based only on ads or brochures are doing so without the facts they need to make informed decisions.

Her study, of 20 brochures and 40 ads in several major U.S. newspapers, found that these sources often made statements about full-body CT and MRI screening that were “scientifically unsupported,” and many used negative, sometimes fear-evoking, tactics to promote the services.

One ad, for example, contained the statement, “I had a time bomb in my body...You need to know.”

In addition, one quarter of the newspaper ads pointed out that the technology is FDA-approved, brushing over the fact that the agency has never approved the scans specifically for screening purposes.

Illes and her colleagues report their findings in the current issue of the Archives of Internal Medicine.

In general, Illes and her colleagues found the ads and brochures urged consumers to take action to protect their own health, while “virtually none” advised them to first consult their doctors or mentioned the risks of having a scan.

These risks include the possibility of having a false-positive result or having a scan pick up a “suspicious” finding that would never have presented a significant health risk—two scenarios that could lead to further, unnecessary medical procedures and needless anxiety.

CT scans, which involve computerized X-rays that create three-dimensional images of the body, expose patients to a level of radiation far higher than that of traditional X-rays.

Illes advised that anyone who is interested in image-based screening first talk with their doctors about the potential benefits and risks.

An editorial published with the report calls the findings “disturbing” and urges greater oversight of ads for image-based screening.

“An oversight system comparable to FDA regulation of pharmaceutical advertising is sorely needed,” write Drs. Patrick G. O’Malley and Allen J. Taylor of Walter Reed Army Medical Center in Washington, DC.

In contrast to the marketing of MRI and CT scans, drug advertisements are required to balance information on benefits with information on potential risks. They also direct consumers to other sources of information, including their doctors, Illes pointed out.

She said comparable oversight of MRI and CT marketing could “really benefit consumers in terms of their ability to make informed decisions.”

SOURCE: Archives of Internal Medicine, December 13/27, 2004.

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