title: An historical cohort study of cardiac catheterization during childhood and the risk of cancer.
abstract: This study aimed to determine whether cancer risk was elevated among patients exposed to radiation from diagnostic cardiac catheterization during childhood. The study cohort included 3915 children who underwent at least one cardiac catheterization at a major children's hospital in Toronto, Canada, between 1950 and 1965, were < or = 18 years at the time of the procedure, and were residents of Ontario. Follow-up of the cohort was done by linkage to the Ontario Cancer Registry up to 1986. A total of seven cancer deaths were observed (O), compared with 5.7 expected (E) based on provincial cancer rates (mortality ratio [O/E] = 1.2; 90% confidence interval [CI] : 0.6-2.3). In the analysis of cancer incidence, 13 cancers were detected, compared with 17.3 expected (O/E = 0.75; 90% CI : 0.4-1.2). These mortality and incidence ratios were not statistically significantly elevated. Detailed analyses were conducted according to age at exposure, age at diagnosis, sex, number of procedures, year of first catheterization, and latent period. Detected deviations in risk were confined to an early period of exposure, indicating that later practices of cardiac catheterization were not associated with increased risk. In general, there was no statistically significant excess risk of cancer among the cohort.
authors.affiliation: Division of Epidemiology and Statistics, Ontario Cancer Treatment and Research Foundation, Toronto, Canada.
authors.forename: J R
authors.initials: JR
authors.lastname: McLaughlin
authors.forename: N
authors.initials: N
authors.lastname: Kreiger
authors.forename: M P
authors.initials: MP
authors.lastname: Sloan
authors.forename: L N
authors.initials: LN
authors.lastname: Benson
authors.forename: S
authors.initials: S
authors.lastname: Hilditch
authors.forename: E A
authors.initials: EA
authors.lastname: Clarke
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008498:Medical Record Linkage; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D009864:Ontario / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D014505:Urban Population