SRS86 Patey Prize Entrant - A nationwide cohort study examining the risk of cancer after endovascular abdominal aortic aneurysm repair

Introduction Endovascular aneurysm repair (EVAR) is an X-ray guided procedure that is now a mainstay for treatment for abdominal aortic aneurysms (AAAs). The present study leveraged large scale analysis of clinical data to investigate the risk of cancer in EVAR patients. Methods Patients aged 50 and over admitted to hospital with ICD-10 codes for AAA from 2005 to 2018 were identified from the Hospital Episode Statistics (HES) database. Patients were divided into the non-operated (NOP), open aneurysm repair (OAR), and EVAR groups. The data were linked with the National Cancer Registration Service to identify subsequent cancer diagnoses. Person-years at risk were accumulated to calculate the relative risk (RR) of cancers. Results 97 591 AAA patients were identified, 33 873 had OAR, 30 552 had EVAR, and 33 166 were NOP. The follow-up period was 18 years. The operative groups showed an increased RR of lung, oesophageal, colonic, bladder, prostate, and skin cancers compared with NOP group. The EVAR group had an increased RR (1.47 (1.13–1.91), P < 0.05) of liver cancer compared to OAR group. There was no difference in the overall RR of cancer between the OAR and EVAR groups. Among patients who underwent two or three endovascular procedures, 19 and 27.5% had subsequent cancer diagnoses. Conclusions Patients who had AAA operations had an increased risk of lung, abdominal, and pelvic cancers. Those who underwent EVAR had a higher risk of liver cancer than those who had open repair, but there was no difference in overall cancer risk.