A new study from a single quaternary-care academic hospital has found that the proportion of CT scans performed on patients aged 60 to 90 rose from 50.4% in 2014 to 58.3% in 2024, representing a significant shift in how diagnostic imaging is being distributed across age groups. The findings, which reflect a decade of imaging data, are drawing fresh scrutiny from medical professionals over the long-term radiation risks associated with repeat CT scanning in older populations. Researchers say the trend mirrors broader patterns seen across healthcare systems and raises important questions about clinical decision-making.
CT scans expose patients to ionising radiation, and while a single scan carries a relatively low individual risk, cumulative exposure from multiple scans over time has been linked to a measurably increased risk of radiation-induced cancer. For older adults, who often present with multiple chronic conditions requiring ongoing diagnostic monitoring, the likelihood of repeat imaging is substantially higher than in younger patients. Medical experts note that the risk-benefit calculation for CT use in elderly patients is complex, particularly given that the latency period for radiation-induced cancers can span several decades.
The debate centres not only on radiation exposure but also on the concept of low-value imaging — scans that are ordered without sufficient clinical justification or that are unlikely to change patient management. Studies suggest that a notable percentage of CT scans across all age groups may fall into this category, and that older adults, who frequently see multiple specialists, are at particular risk of receiving duplicated or unnecessary imaging. Clinicians and radiologists are being urged to apply stricter criteria when ordering CT scans for elderly patients, including greater use of clinical decision support tools.
Advocates for the elderly population argue that age alone should not be used as a barrier to accessing diagnostic imaging, emphasising that timely and accurate diagnosis is critical for effective treatment outcomes in older patients. However, researchers involved in the study suggest that healthcare systems need to develop more robust frameworks for tracking cumulative radiation doses in individual patients over time. Electronic health records, they argue, should be better equipped to flag patients who have already received significant radiation exposure, enabling clinicians to consider alternative imaging modalities such as MRI or ultrasound.
The findings are expected to prompt further review by radiology and geriatric medicine bodies regarding best practices for CT ordering in the over-60 demographic. While the data originates from a single academic institution and may not be universally representative, experts say the pattern is consistent with trends observed in larger, multi-site analyses. Healthcare administrators and policymakers are now being called upon to consider whether updated national guidelines are needed to address the growing volume of CT imaging among elderly patients and ensure that radiation exposure is being appropriately managed across the healthcare continuum.
