CHD and Cancer: Is there a connection?

Research shows there may be an increased risk of cancer for people living with congenital heart disease, both children and adults. The cardio oncology field is just beginning to look at the possible connection.

A 2018-2019 registry-based cohort study in Sweden, which included 21,000+ individuals with CHD and 219,000+ healthy individuals, all born between 1970-1993, concluded those with CHD may have a “2-fold higher risk of cancer” when compared to the healthy individuals.

“The findings suggest that children and young adults with congenital heart disease have an increased risk of cancer, and a systematic screening for cancer could be considered for this at-risk group of patients.”

In 2017, physicians published research in Circulation, regarding the level of low-dose ionizing radiation from cardiac procedures in adults with CHD, and how that may affect their risk for cancer.

“To our knowledge, this is the first large population-based study to analyze and document the association between LDIR-related cardiac procedures and incident cancer in the population of adults with CHD. Confirmations of these findings by prospective studies are needed to reinforce policy recommendations for radiation surveillance in patients with CHD where no regulation currently exists. Physicians ordering and performing cardiac imaging should ensure that exposure is as low as reasonably achievable without sacrificing quality of care.”

An adult congenital cardiologist at Boston Children’s Hospital, and Professor at Harvard Medical School, penned an article in 2019 providing increasing evidence for, and a word of caution about, the association between congenital heart disease and cancer.

“Thus far, most of the literature on the association between CHD and cancer has used administrative data but has established consistent associations, and the studies have hypothesized plausible mechanisms. It is now time to move beyond associations to explore clinical and translational research to determine better screening and treatment models for the population of patients with CHD. Although this will take time and larger numbers of patients to determine conclusions, cardiologists specializing in CHD, primary care clinicians, and patient and family organizations can continue to advocate for further research in this important area, mitigation of concerning exposures, and accomplishment of recommended cancer screening for patients with CHD.”

Key Takeaways

  • The link between congenital heart disease and cancer is being studied
  • Examinations of patient registries show some correlation but don’t agree on level of increased risk
  • Future studies should be clinically based
  • Patients living with CHD, especially middle-aged and older adults, should be screened for cancer as appropriate

Patients and families wanting to read further can visit the National Institute of Health’s Library of Medicine.

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