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Cancer risk varies by radiation exposure during cardiac catheterization in children
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Patients who received doses of radiation during cardiac catheterization procedures had a large variability regarding their risk for cancer, according to a study published in Circulation: Cardiovascular Interventions.
Neige Journy, PhD, epidemiologist at the French Institute of Health and Medical Research in Paris, and colleagues analyzed data from 1,175 children who underwent 1,251 procedures in France from 2009 to 2013. Procedures included in this study were atrial septal defect closure, pulmonary valvuloplasty and patent ductus arteriosus occlusion. Researchers assessed radiation exposure scenarios and calculated sex-specific lifetime attributable risk.
Patients who underwent atrial septal defect closure had a median lifetime adjustable risk between 0.3 per 1,000 procedures and 1.4 per 1,000 procedures. The risk in patients who underwent patent ductus arteriosus occlusion was between 0.6 per 1,000 procedures and 5 per 1,000 procedures, and those who underwent pulmonary valvuloplasty had a median lifetime adjustable risk between 1 per 1,000 procedures and 12 per 1,000 procedures. All of these risks varied depending on the age at treatment and patient sex. The calculated lifetime adjustable risk represented 0.4% to 6% of the total lifetime cancer risk in children.
In the 10% of procedures with the highest exposures to radiation, boys had a lifetime adjustable risk of 4.2 per 1,000 procedures (95% uncertainty interval, 0.8-13.1) compared with 22.2 per 1,000 procedures in girls (95% uncertainty interval, 7.4-45.6).
Lung cancer accounted for 70% to 80% of the projected lifetime adjustable risk in boys compared with 20% to 60% in girls. Breast cancer contributed to 30% to 80% of excess risks in girls.
“At the present time, the high degree of individual dose variability and the possible accumulation of radiological exposures for management of [congenital heart diseases], and their potential subsequent comorbidities suggests the need for systematic dose reporting to support recommendations for long-term surveillance and prevention strategies, particularly for lung and breast cancers,” Journy and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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