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Cancer risk from diagnostic radiology in a deliberate self-harm patient

Authors

  • L. J. Norelli,

    1. Capital District Psychiatric Center, Albany, NY, USA
    2. Albany Medical College, Department of Psychiatry, Albany, NY, USA
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  • A. D. Coates,

    1. Capital District Psychiatric Center, Albany, NY, USA
    2. Albany Medical College, Department of Psychiatry, Albany, NY, USA
    3. Albany Medical College, Department of Medicine, Albany, NY, USA
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  • B. M. Kovasznay

    1. Capital District Psychiatric Center, Albany, NY, USA
    2. Albany Medical College, Department of Psychiatry, Albany, NY, USA
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Doctor Lisa J. Norelli, Capital District Psychiatric Center, 75 New Scotland Avenue, Albany, NY 12208, USA.
E-mail: cdfmljn@omh.state.ny.us

Abstract

Norelli LJ, Coates AD, Kovasznay BM. Cancer risk from diagnostic radiology in a deliberate self-harm patient.

Objective:  Patients who engage in recurrent deliberate self-harm (DSH) behaviours have increased morbidity and mortality and use emergency services more than others. Unrecognized iatrogenic injury may play a role. Specifically, we call attention to the potential danger of cumulative radiation exposure.

Method:  Case presentation and discussion.

Results:  A 29-year-old woman with multiple episodes of deliberate foreign body ingestion received over 400 diagnostic radiology examinations during a 12 year period. The patient’s calculated total radiation dose reached an average of 20.5 mSv per year, a dose comparable to atomic bomb survivors and nuclear industry workers, populations in which there is a significant excess cancer risk.

Conclusion:  Patients with recurrent self-injurious behaviours, frequent users of healthcare services who often undergo repeated medical assessment and treatment, are likely at higher risk for iatrogenic adverse events. Multiple diagnostic radiology examinations have recently come under scrutiny for causing increased lifetime risk of cancer. Healthcare providers, in particular psychiatrists and emergency department physicians, should consider the cumulative risks of radiological procedures when assessing and treating patients with DSH.

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