We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Radiation-Related Cancer Risk Associated With Radiographic Imaging—Reply

Joanne C. Wen, MD1; Victor Sai, MD2; Bradley R. Straatsma, MD, JD1; Tara A. McCannel, MD, PhD1
[+] Author Affiliations
1Jules Stein Eye Institute, University of California, Los Angeles
2Department of Radiology and Biomedical Imaging, University of California, San Francisco
JAMA Ophthalmol. 2013;131(9):1249. doi:10.1001/jamaophthalmol.2013.4507.
Text Size: A A A
Published online


In Reply We appreciate the interest and comments from Finger and colleagues. However, we respectfully disagree that our article overly emphasized the risks of aggressive metastatic surveillance. In our article, we presented numerous clinical regimens including single whole-body PET/CT scan, single CT scan of the chest/abdomen/pelvis, annual or biannual scans for 5- or 10-year periods, and calculated lifetime attributable risks for each of these protocols, in addition to the most aggressive surveillance protocol. While we did not specifically calculate the risk of a yearly abdominal CT in a 60-year-old patient with choroidal melanoma as Finger and colleagues suggested would constitute a more typical regimen, we did calculate and report the lifetime attributable risk of a yearly CT scan of the chest/abdomen/pelvis in a 50-year-old patient with choroidal melanoma as 0.9% for men and 1.3% for women over a 10-year period. We chose to estimate the lifetime attributable risk of cancer for 20-year-old men and women with an aggressive surveillance protocol to demonstrate the upper limits of cancer risks and also to emphasize to the clinician that younger patients carry higher risks. Our references to “significant” radiation risks were made with respect to these aggressive surveillance protocols and not to single or occasional imaging studies.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





September 1, 2013
Paul T. Finger, MD; Aurélien Freton, MD; Anna Pavlick, DO
1The New York Eye Cancer Center, New York
2New York University School of Medicine Comprehensive Cancer Center, New York
JAMA Ophthalmol. 2013;131(9):1248-1249. doi:10.1001/jamaophthalmol.2013.4025.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Related Collections