Cardiac catheterization before 8 years of age was associated with an increased cancer risk compared to expected population rates (SIR 1.88; 95% CI 0.90-3.46; p=0.0449).
Cohort (n=2,762)
No
Does cardiac catheterization early in life increase the risk of malignancy in children with congenital heart disease?
Cardiac catheterization early in life remains associated with an increased cancer risk in children with congenital heart disease, although this risk has decreased compared to earlier historical cohorts.
Effect estimate: SIR 1.88 (95% CI 0.90-3.46)
Absolute Event Rate: 0.36% vs 0.19%
p-value: p=0.0449
Background/Objectives: Children with congenital heart disease are exposed to ionizing radiation, which may induce cancer. This study aimed to reassess cancer risk after cardiac catheterization (CC) between 1999 and 2013, with follow-up until 15 years of age, cancer diagnosis, or death. Methods: We studied 2762 children who underwent at least one CC before eight years of age between 1999 and 2013. Cancer diagnoses were obtained from the German Childhood Cancer Registry. For patients with tumors and 60 randomly selected control patients, cumulative effective radiation doses (Deff) were calculated. Results: During 344, 80 person-years of follow-up, ten patients developed cancer, whereas 5. 3 cases were expected (standardized incidence ratio SIR 1. 88; 95% CI 0. 90–3. 46; p = 0. 0449). Eight tumors occurred in patients who underwent CC during the first year of life, compared with 3. 5 expected (SIR 2. 26; 95% CI 0. 98–4. 46; p = 0. 0282). Patients with cancer had a median of 2. 0 (1–11) CCs and a median Dₑff of 14. 6 mSv (2. 4–94. 3) compared with 1. 0 (1–10) CCs and 9. 7 mSv (0. 7–171. 5) in controls. Neither parameter differed significantly. No specific malignancy was predominant. Conclusion: Cardiac catheterization early in life remains associated with an increased cancer risk; however, compared with our previously published 1980–1998 cohort, a reduction in risk was observed.
Stern et al. (Fri,) conducted a cohort in Congenital heart disease (n=2,762). Cardiac catheterization vs. Expected population rates was evaluated on Cancer diagnosis (SIR 1.88, 95% CI 0.90-3.46, p=0.0449). Cardiac catheterization before 8 years of age was associated with an increased cancer risk compared to expected population rates (SIR 1.88; 95% CI 0.90-3.46; p=0.0449).