"CT scanning became widespread in the 1980's. Cancer incidence is flat to slightly decreased since then. I'm not sure their risk model matches reality. Many of these models are based on extrapolation from higher radiation exposures and there may be a fundamental issue with how they estimate risk." https://x.com/NathanRuch/status/1911803050857050502

From the paper itself: "We projected future lifetime radiation-induced cancer risk using the National Cancer Institute’s Radiation Risk Assessment Tool (RadRAT) software version 4.3.1, which utilizes risk models from the National Academy of Sciences’ Biologic Effects of Ionizing Radiation (BEIR) VII report for 11 site-specific cancers ... using a more recent follow-up of the Japanese atomic bomb survivors and pooled analyses of other medically exposed cohorts."

So I wouldn't hang my hat on the claim "that CT examinations in 2023 were projected to result in approximately 103,000 future cancers over the course of the lifetime of exposed patients."

Are CTs without risk? Of course not but quantifying that risk isn't easy with the data and models we have available. We should be glad that the authors are trying to do so but also be cautious about publicizing their estimate as an eye-catching headline. Since most who read the headline will over interpret it as an established scientific fact that meets a higher level of evidence than has actually been met.