Cancer Risk in Congenital Heart Disease—What Is the Evidence?

Publication date: December 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 12Author(s): Sarah Cohen, Michelle Z. Gurvitz, Virginie Beauséjour-Ladouceur, Patrick R. Lawler, Judith Therrien, Ariane J. MarelliAbstractAs life expectancy in patients with congenital heart disease (CHD) has improved, the risk for developing noncardiac morbidities is increasing in adult patients with CHD (ACHD). Among these noncardiac complications, malignancies significantly contribute to the disease burden of ACHD patients. Epidemiologic studies of cancer risk in CHD patients are challenging because they require large numbers of patients, extended follow-up, detailed and validated clinical data, and appropriate reference populations. However, several observational studies suggest that cancer risks are significantly elevated in patients with CHD compared with the general population. CHD and cancer share genetic and environmental risk factors. An association with exposure to low-dose ionizing radiation secondary to medical therapeutic or diagnostic procedures has been reported. Patients with Down syndrome, as well as, to a lesser extent, deletion of 22q11.2 and renin-angiotensin system pathologies, may manifest both CHD and a predisposition to cancer. Such observations suggest that carcinogenesis and CHD may share a common basis in some cases. Finally, specific conditions, such as Fontan circulation and cyanotic CHD, may lead to multisystem consequences and subsequently to cancer. Nonet...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research