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Lookup NU author(s): Dr Richard Harbron, Dr Claire-Louise Chapple, Dr John O'Sullivan, Dr Manuel Higueras, Professor Mark PearceORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Children and young adults with heart disease appear to be at increased risk of developing cancer,although the reasons for this are unclear. A cohort of 11,270 individuals, who underwent cardiaccatheterizations while aged ≤22 years in the UK, was established from hospital records. Radiationdoses from cardiac catheterizations and CT scans were estimated. The cohort was matched with theNHS Central Register and NHS Transplant Registry to determine cancer incidence and transplantationstatus. Standardized incidence ratios (SIR) with associated confidence intervals (CI) were calculated.The excess relative risk (ERR) of haematological neoplasia was also calculated using Poissonregression. The SIR was raised for all malignancies (2.32, 95% CI: 1.65, 3.17), lymphoma (8.34, 95%CI: 5.22, 12.61) and leukaemia (2.11, 95% CI: 0.82, 4.42). After censoring transplant recipients, posttransplant,the SIR was reduced to 0.90 (95% CI: 0.49, 1.49) for all malignancies. All lymphomasdeveloped post-transplant. The SIR for all malignancies developing 5 years from the first cardiaccatheterization (2 years for leukaemia/lymphoma) remained raised (3.01, 95% CI: 2.09, 4.19) but wasagain reduced after censoring transplant recipients (0.98, 95% CI: 0.48, 1.77). The ERR per mGybone marrow dose for haematological neoplasia was reduced from 0.541 (95% CI: 0.104, 1.807) to0.018 (95% CI: -0.002, 0.096) where transplantation status was accounted for as a time-dependentbackground risk factor. In conclusion, transplantation appears to be a large contributor to elevatedcancer rates in this patient group. This is likely to be mainly due to associated immunosuppression,however, radiation exposure may also be a contributing factor.
Author(s): Harbron RW, Chapple CL, O'Sullivan JJ, Lee C, McHugh K, Higueras M, Pearce MS
Publication type: Article
Publication status: Published
Journal: European Journal of Epidemiology
Year: 2018
Volume: 33
Issue: 4
Pages: 393-401
Print publication date: 01/04/2018
Online publication date: 18/01/2018
Acceptance date: 06/01/2018
Date deposited: 12/01/2018
ISSN (print): 0393-2990
ISSN (electronic): 1573-7284
Publisher: Springer
URL: https://doi.org/10.1007/s10654-018-0357-0
DOI: 10.1007/s10654-018-0357-0
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