Incidence of Cancer in Adult patients with Congenital Heart Disease

Adults with congenital heart disease are exposed to cumulative radiation doses, from multiple catheterization procedures. Seeing as these patients are exposed since early age, the chance of stochastic effect due to radiation exposure are relatively higher than that of the elderly population.

Incidencia de cáncer en pacientes adultos con cardiopatías congénitas

It is clear the chance of incident cancer in adults with congenital heart disease is higher than that of the general population but, so far, there are no figures to estimate this association.


Read also: “Protective Shield RADPAD Reduces the Radiation Dose Received by Operators in the Cath Lab”.


The study population was obtained from the Quebec database. The study looked at cumulative doses during cardiac procedures for each patient until one-year prior cancer diagnosis.

 

The study included 24833 patients with congenital heart disease between 18 and 64 years from 1995 to 2009. After following up 250791 patients/year, researchers observed 602 cases of cancer at mean 55.4 years.

 

Cancer cumulative incidence at 64 years was estimated in 15.3% (CI 95%; 14.2-16.5).


Read also: “Radiation Exposure in Chronic Total Occlusions”.


Cancer patients had a bigger number of catheterization procedures than control patients. (1410 vs 921 every 1000 patients with congenital heart disease; p<0.0001).

 

Radiation was independently associated with cancer, both per procedure (OR: 1.08; CI 95%, 1.04-1.13) and per dose (OR: 1.10 per every 10 milliSieverts; CI 95%, 1.05 1.15).

 

Conclusion

This is the first large population-based study to look at the association between radiation exposure in cardiac procedures and the incidence of cancer in adults with congenital heart disease.

 

Editorial Comment

These findings should be confirmed by prospective studies to reinforce recommendations on radiation surveillance in a highly, early exposed population. This is vital if we are to standardize cancer prevention policies, currently non-existent. 

 

For now, physicians must ensure diagnostic and therapeutic procedures with the lowest possible radiation dose, without compromising quality.

 

Original title: Exposure to Low-Dose Ionizing Radiation from Cardiac Procedures and Malignancy Risk in Adults with Congenital Heart Disease Running.

Reference: Cohen et al. Circulation. 2017 Dec 21. [Epub ahead of print].


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TAVR in Small Annuli: What Valve Should We Use?

One of the major challenges of severe aortic stenosis are patients with small aortic annuli, defined as ≤430 mm² aortic valve area. This condition...

ACC 2025 | TAVI in Low-Risk Patients: 5-Year Outcomes of EVOLUTE LOW RISK

Transcatheter aortic valve implantation (TAVI) is a valid alternative to surgery in low-risk patients with severe aortic stenosis. However, one of its main limitations...

ACC 2025 | BHF PROTECT-TAVI: Are Cerebral Protection Systems Necessary in TAVI?

TAVI has seen a steady increase in use, though stroke continues to be one of its unwanted complications, mostly ischemic and, less frequently, hemorrhagic. The...

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

RACE Trial: Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in Chronic Thromboembolic Pulmonary Hypertension

Even though pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), up to 40% of patients are not candidates because...

iFR- vs. FFR-Guided Coronary Revascularization: 5-Year Clinical Outcomes

The assessment of coronary stenosis using coronary physiology has become a key tool in guiding revascularization. The two most widely used techniques are fractional...

TAVR in Small Annuli: What Valve Should We Use?

One of the major challenges of severe aortic stenosis are patients with small aortic annuli, defined as ≤430 mm² aortic valve area. This condition...