Radiography — Advice Letter to a Patient Concerned about Radiation from Repeated CT Scans
A radiographer writes an advice letter to a 45-year-old woman with Crohn's disease who has expressed significant concern about the radiation dose from her repeated CT scans. This beginner case requires explaining the radiation risk in plain, reassuring, and accurate language.
Letter type
Advice
Write to
Patient
Target length
180–200 words
The case notes
Patient: Mrs Alicia Ferreira, 45 years old; Crohn's disease — 4 CT abdomen/pelvis scans over the past 5 years (one annually)
Patient concern: Read an article stating that CT scans significantly increase cancer risk; very anxious; requested a letter explaining her situation; considering refusing future scans
Radiation context: CT abdomen/pelvis dose: approximately 8–10 mSv per scan; natural background radiation dose per year in UK: approximately 2.7 mSv; 4 CT scans over 5 years = approximately 32–40 mSv cumulative; this is equivalent to approximately 12–15 years of background radiation
Risk in context: The additional lifetime cancer risk from the cumulative CT dose is estimated at approximately 0.2% — a small but real risk; compared with background lifetime cancer risk of approximately 40% in the general population; the CT scans have provided the clinical information needed to manage active Crohn's disease and have detected two complications requiring treatment
Justification: Every CT scan is justified by a radiologist and/or clinician before it is performed — it is approved only when the clinical benefit outweighs the radiation risk; scans are not ordered routinely; ALARP principle (As Low As Reasonably Practicable) means the dose is kept as low as possible
Alternatives: MRI (no radiation) is increasingly used for Crohn's monitoring; her gastroenterologist has noted this is being reviewed for future imaging
Task: Write an advice letter to Mrs Ferreira addressing her radiation concerns, explaining the risk in plain language, and reassuring her about the justification process.
Writing task
Write an advice letter to Mrs Ferreira addressing her radiation concerns, explaining the risk in plain language, and reassuring her about the justification process.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The cumulative dose in context: equivalent to approximately 12–15 years of background radiation, additional cancer risk approximately 0.2%
Abstract numbers ('32–40 mSv') mean nothing to a patient. Background radiation equivalence is the most effective way to contextualise CT radiation risk for a non-specialist. The 0.2% additional risk compared to the 40% background risk gives the patient a proportionate picture.
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That every scan is justified by a clinician before it is approved — not ordered routinely
The patient's anxiety is partly driven by the perception that scans are routine or automatic. Knowing that each one was medically justified by a qualified person and that the clinical benefit was weighed against the radiation risk directly addresses her concern.
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That MRI is being reviewed as a radiation-free alternative for future monitoring
This shows the medical team is proactively managing the cumulative dose concern and is already planning a lower-radiation approach. It is the most reassuring forward-looking statement in the letter.
Leave out
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A detailed radiation dosimetry explanation
Millisieverts, effective dose coefficients, and tissue weighting factors are not appropriate for a patient advice letter. Use equivalences (years of background radiation) and plain-language risk framing (0.2% additional risk).
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A full Crohn's disease history and the complications treated
'The scans have provided the clinical information needed to manage your Crohn's disease and have detected two complications requiring treatment' is enough. The patient knows her history; the letter provides the radiation context, not a medical summary.
Criterion in focus · Genre & Style
A radiation concerns letter is written to an anxious patient who is considering refusing future scans. The genre requires a careful balance: accurate about the risk (not dismissing it) but clear about the context and the clinical benefit. 'The radiation is negligible' is inaccurate and dismissive. 'The radiation risk from your scans is small — equivalent to about 15 years of natural background radiation — and has been weighed carefully against the clinical information the scans have provided.' This is accurate, contextualised, and respectful of the patient's concern.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.