Congenital heart defects may increase cancer risk


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Adults with congenital heart defects had a high risk of developing cancer, according to results published in JAMA network open.

The researchers also found that the risk of cancer was significantly higher in adults with complex heart lesions and suggested the need for increased screening.

Zechariah Mandalenakis, MD, PhD, FESC, and colleagues studied the risk of developing cancer from birth to age 41 in patients with congenital heart defects compared to healthy matched controls.

“Unlike many other cardiovascular disorders, [congenital heart defects are] present from birth, ”wrote Mandalenakis, postdoctoral student at Gothenburg University in Sweden, and colleagues. “However, to our knowledge, no studies have observed patients with [congenital heart disease] from birth and compared their cancer outcomes with matched controls.

The researchers analyzed data from Swedish patient registers and causes of death. Cohorts of patients with congenital heart defects born between 1970 and 1979, 1980 and 1989, and 1990 and 1993 have been found.

Patients with congenital heart defects (n = 21,982) were matched for year of birth, sex, and country and with 10 controls without congenital heart defects from the general population (n = 219,816), Mandalenakis wrote. and his colleagues.

The primary outcome measure was the risk of cancer in children and young adults.

Mandalenakis and his 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% of men) have developed cancer.

Adults with congenital heart defects had a high risk of developing cancer, according to results published in JAMA network open.

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In children and adults with congenital heart defects, there was a risk of cancer compared to controls (HR = 2.24; 95% CI, 2.01 to 2.48), the researchers wrote, noting that the risk increased in each successive birth cohort, peaking with a plus three times the risk in people born between 1990 and 1993 (HR = 3.37; 95% CI: 2.6-4.35).

There were similarities in cancer risk in 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 to 2.41), Mandalenakis and colleagues wrote.

Compared to controls, patients with congenital heart defects who underwent surgery had an RR of 1.95 (95% CI, 1.58-2.33) and patients with congenital heart defects who did not. had not had surgery had an RR of 2.43 (95% CI, 2.12-2.76). ), wrote the researchers.

In patients with conotrucal abnormalities, there was a significantly increased risk of cancer compared to control groups (HR = 2.29; 95% CI: 1.62-3.25), wrote Mandalenakis and colleagues. .

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“This finding suggests that special attention should be paid to the warning signs of cancer and the promotion of a healthy lifestyle,” the researchers wrote. “Further research into the mechanisms of cancer in this young group of patients is warranted.” – by Earl Holland Jr.

Disclosures: The authors do not report any relevant financial disclosures.