title: Oncology Patient Perceptions of the Use of Ionizing Radiation in Diagnostic Imaging.
abstract: OBJECTIVE
  To measure the knowledge of oncology patients regarding use and potential risks of ionizing radiation in diagnostic imaging.
  
  
  METHODS
  A 30-question survey was developed and e-mailed to 48,736 randomly selected patients who had undergone a diagnostic imaging study at a comprehensive cancer center between November 1, 2013 and January 31, 2014. The survey was designed to measure patients' knowledge about use of ionizing radiation in diagnostic imaging and attitudes about radiation. Nonresponse bias was quantified by sending an abbreviated survey to patients who did not respond to the original survey.
  
  
  RESULTS
  Of the 48,736 individuals who were sent the initial survey, 9,098 (18.7%) opened it, and 5,462 (11.2%) completed it. A total of 21.7% of respondents reported knowing the definition of ionizing radiation; 35.1% stated correctly that CT used ionizing radiation; and 29.4% stated incorrectly that MRI used ionizing radiation. Many respondents did not understand risks from exposure to diagnostic doses of ionizing radiation: Of 3,139 respondents who believed that an abdominopelvic CT scan carried risk, 1,283 (40.9%) believed sterility was a risk; 669 (21.3%) believed heritable mutations were a risk; 657 (20.9%) believed acute radiation sickness was a risk; and 135 (4.3%) believed cataracts were a risk.
  
  
  CONCLUSIONS
  Most patients and caregivers do not possess basic knowledge regarding the use of ionizing radiation in oncologic diagnostic imaging. To ensure health literacy and high-quality patient decision making, efforts to educate patients and caregivers should be increased. Such education might begin with information about effects that are not risks of diagnostic imaging.
authors.affiliation: Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: jsteele1@mdanderson.org.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Steele
authors.affiliation: Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Jones
authors.affiliation: Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Clarke
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Giordano
authors.affiliation: William F. Harrah College of Hotel Administration, University of Nevada, Las Vegas, Las Vegas, Nevada.
authors.forename: Stowe
authors.initials: S
authors.lastname: Shoemaker
mesh_terms: D001294:Attitude to Health; D003952:Diagnostic Imaging / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011832:Radiation Injuries / Q000453:epidemiology* / Q000523:psychology; D018787:Radiation Oncology / Q000706:statistics & numerical data; D011839:Radiation, Ionizing; D018570:Risk Assessment / Q000706:statistics & numerical data; D013781:Texas / Q000453:epidemiology
keywords: CT; MRI; Radiation; caregiver; health literacy; ionizing; patient education