Coronary angioplasty and cancer risk: a population-based cohort study in Sweden.
BACKGROUND
Percutaneous transluminal coronary angioplasty (PTCA) has become the reperfusion method of choice in patients with coronary artery disease. This sometimes complicated and lengthy procedure is performed using fluoroscopy and cineradiography or digital imaging, which may result in considerable exposure to ionizing radiation. Possible cancer risks in PTCA patients have been discussed, but never before examined in a population-based setting.


OBJECTIVE
To assess the cancer risks following PTCA.


METHODS
A cohort study was carried out based on nationwide registration of all coronary angioplasty procedures in Sweden between 1989 and 1998. The study encompassed a total of 23,097 PTCA patients followed up for cancer outcomes in the Swedish Cancer Register until December 31, 2000. The mean and median follow-up times were 4.8 and 4.5 years, respectively. The main outcome measures were standardized incidence ratios of cancer.


RESULTS
Except for a transient excess of lung cancers, observed number of cancers in patients who had undergone coronary angioplasty did not differ from those expected in the general population. If anything, the overall cancer risk was lower in the PTCA group (SIR 0.94; 95% CI 0.88-0.99). In particular, no increased risks were detected for leukemias or thyroid cancer.


CONCLUSIONS
There was no indication of increased risks of leukemia or cancers overall in PTCA patients.
Lambe
M
M
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, 171 77 Stockholm, Sweden. mats.lambe@meb.ki.se
Hall
P
P
Granath
F
F
Sadr Azodi
O
O
Nilsson
T
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D015641:Radiography, Interventional / Q000009:adverse effects*; D012042:Registries; D012306:Risk; D013548:Sweden / Q000453:epidemiology