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Congenital heart defects may confer increased odds for cancer
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Adults with congenital heart defects had elevated risk for developing cancer, according to findings published in JAMA Network Open.
The researchers also found that the risk for cancer was significantly greater in adults with complex heart lesions and suggested a need for increased screening.
Zacharias Mandalenakis, MD, PhD, FESC, and colleagues investigated the risk for developing cancer from birth to age 41 years among patients with congenital heart defects compared with healthy matched controls.
“In contrast to many other cardiovascular disorders, [congenital heart defects are] present from birth,” Mandalenakis, a postdoctoral student at the University of Gothenburg in Sweden, and colleagues wrote. “However, to our knowledge, no study has observed patients with [congenital heart disease] from birth and compared their cancer outcomes with matched controls.”
The researchers analyzed data from Swedish patient and cause of death registries. Cohorts of patients with congenital heart defects born between 1970 and 1979, 1980 and 1989, and 1990 and 1993 were found.
Patients with congenital heart defects (n = 21,982) were matched for birth year, sex and country and with 10 controls without congenital heart defects from the general population (n = 219,816), Mandalenakis and colleagues wrote.
The primary outcome was cancer risk among children and young adults.
Mandalenakis and colleagues discerned 2% of patients with congenital heart defects (mean age at follow-up, 27 years; 52% men) and 0.9% of controls (mean age at follow-up, 28 years; 52% men) developed cancer.
In children and adults with congenital heart defects, there was a risk for cancer compared with controls (HR = 2.24; 95% CI, 2.01-2.48), the researchers wrote, noting the risk increased in each successive birth cohort, culminating with a more than threefold higher risk in those born between 1990 and 1993 (HR = 3.37; 95% CI, 2.6-4.35).
There were similarities in the risk for cancer in both men and women with congenital heart defects (HR for men = 2.41; 95% CI, 2.08-2.79; HR for women = 2.08; 95% CI, 1.8-2.41), Mandalenakis and colleagues wrote.
Compared with controls, patients with congenital heart defects who had surgery had a HR of 1.95 (95% CI, 1.58-2.33) and patients with congenital heart defects who did not have surgery had a HR of 2.43 (95% CI, 2.12-2.76), the researchers wrote.
In patients with conotruncal defects, there was a significant increase in cancer risk compared with the control groups (HR = 2.29; 95% CI, 1.62-3.25), Mandalenakis and colleagues wrote.
“This finding suggests that particular attention should be paid to early warning signs of cancer and promotion of a healthy lifestyle,” the researchers wrote. “Further research on the mechanisms of cancer in this young patient group is warranted.” – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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