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Cancer risk among patients with congenital heart defects: a nationwide follow-up study

Published online by Cambridge University Press:  18 January 2013

Morten Olsen ,
Ester Garne ,
Claus Sværke ,
Lars Søndergaard ,
Henrik Nissen ,
Henrik Ø. Andersen ,
Vibeke E. Hjortdal ,
Søren P. Johnsen  and
Jørgen Videbæk
Morten Olsen*
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Ester Garne
Affiliation:
Department of Paediatrics, Hospital Lillebaelt, Kolding, Denmark
Claus Sværke
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Lars Søndergaard
Affiliation:
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Heart Centre, Copenhagen, Denmark
Henrik Nissen
Affiliation:
Department of Cardiology, Odense University Hospital, Odense, Denmark
Henrik Ø. Andersen
Affiliation:
Department of Cardiothoracic Surgery, Rigshospitalet – Copenhagen University Hospital, Heart Centre, Copenhagen, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark
Søren P. Johnsen
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Jørgen Videbæk
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
*
Correspondence to: Dr M. Olsen, MD, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark. Tel: +4589424811; Fax: +4589424801; E-mail: mo@dce.au.dk
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Abstract

Objective

We aimed to assess cancer risk in congenital heart defect patients, with and without Down's syndrome, compared with the general population.

Methods

We identified all patients born and diagnosed with congenital heart defects from 1977 to 2008 using the Danish National Registry of Patients, covering all Danish hospitals. We compared cancer incidence in the congenital heart defect cohort with that expected in the general population (∼5.5 million) using the Danish Cancer Registry, and computed age- and gender-standardised incidence ratios.

Results

We identified 15,905 congenital heart defect patients, contributing a total of 151,172 person-years at risk; the maximum length of follow-up was 31 years (median 8 years). In all, 53 patients were diagnosed with cancer, including 30 female and 23 male patients (standardised incidence ratio = 1.63; 95% confidence interval: 1.22–2.13). Risks were increased for leukaemia, brain tumours, and basal cell carcinoma. After excluding 801 patients with Down's syndrome, the standardised incidence ratio was 1.19 (95% confidence interval: 0.84–1.64). In the subgroup of 5660 non-Down's syndrome patients undergoing cardiac surgery or catheter-based interventions, the standardised incidence ratio was 1.45 (95% confidence interval: 0.86–2.29).

Conclusion

The overall risk of cancer among congenital heart defect patients without Down's syndrome was not statistically significantly elevated. Cancer risk in the congenital heart defect cohort as a whole, including patients with Down's syndrome, was increased compared with the general population, although the absolute risk was low. Studies with longer follow-up and more information on radiation doses are needed to further examine a potential cancer risk associated with diagnostic radiation exposure.

Keywords

Long-term prognosispopulation-based data.
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 40 - 46
Copyright
Copyright © Cambridge University Press 2013 

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