Most annual check-up packages and pre-employment health screenings include a chest X-ray as a default test. But according to Dr Sudhir Kumar, a neurologist at Apollo Hospitals, Hyderabad, doing so without a specific indication can expose you to unnecessary radiation with little clinical benefit.
In a social media post on X, Dr Kumar said that healthy individuals with no symptoms or risk factors rarely require a chest X-ray. He noted that the test “seldom identifies any major illness early” in such cases—and may lead to needless follow-up investigations.
When Is a Chest X-Ray Really Needed?
Rather than include chest imaging as a blanket test, Dr Kumar recommends them only when there are valid medical reasons like:
- Persistent cough, unexplained weight loss, or fever
- History of smoking, or exposure to tuberculosis
- Occupational risk, like toxic or industrial substances
- Lung or heart disease, or symptoms of lung or heart disease
Routine Chest X-Rays Can Be Overkill
Radiation exposure: X-rays emit ionising radiation, which, cumulatively, can damage your DNA and increase your chances of developing cancer over time.
Low diagnostic yield: If no symptoms, and no risk, research shows very few actionable findings out of routine chest X-rays.
Cascade of tests: A benign incidental finding often leads to CT scans or more biopsies, which can add more cost and stress, and may cause harm.
The new mantra is from “more tests = more health” to “the right tests = more health”. This means tests should be designed to the person’s risk and health history, age, symptoms, rather than just checking available slots.
What You Can Do
- Ask the doctor why a particular test is being recommended.
- Clarify if you have symptoms or risk factors that justify a chest X-ray.
- Prioritise lifestyle-based prevention (quit smoking, maintain healthy weight, keep blood pressure/diabetes in check) which offers far greater return than indiscriminate screening.
- Review your annual health check-up package carefully—some tests may be legacy practices rather than evidence-based.
Chest X-rays are useful tools—when clinically indicated. But for healthy, asymptomatic adults, routine screening with X-rays may do more harm than good. Focus on targeted, need-based testing and lead with prevention over paperwork.
FAQs on Routine X-rays
1. Why are chest X-rays commonly included in health check-ups?
Chest X-rays are often part of standard health check-up packages and pre-employment screenings as a routine measure, despite their limited benefit for healthy individuals without symptoms.
2. What are the risks associated with routine chest X-rays?
Routine chest X-rays expose individuals to ionising radiation, which can cumulatively damage DNA and increase the risk of cancer over time.
3. Are there situations where a chest X-ray is necessary?
Yes, chest X-rays are recommended when there are specific medical indications such as persistent cough, unexplained weight loss, fever, history of smoking, exposure to tuberculosis, occupational risks, or symptoms of lung or heart disease.
4. What can I do to avoid unnecessary chest X-rays?
Discuss with your doctor why a chest X-ray is being recommended, ensure you have symptoms or risk factors that justify the test, and prioritise lifestyle-based prevention methods. Review your health check-up package to ensure tests are evidence-based.
Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.
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