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Survival adjusted cancer risks attributable to radiation exposure from cardiac catheterisations in children

Lookup NU author(s): Dr Richard Harbron, Claire Chapple, Dr John O'Sullivan, Kate Best, Professor Mark PearceORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Objectives: To estimate the risk of developing cancer in relation to the typical radiation doses received from a range of x-ray guided cardiac catheterizations in children, taking variable survival into account. Methods: Radiation doses were estimated for 2749 procedures done at 5 UK hospitals using Monte Carlo simulations. The lifetime attributable risk (LAR) of cancer incidence was estimated using models developed by the Biological Effects of Ionising Radiation committee, based on both normal life expectancy, and as a function of attained age, from 20 to 80 years, to take reduced life expectancy into account. Results: The radiation-related risks from these procedures are dominated by lung and breast cancer (for females). Assuming normal life expectancy, central LAR estimates for cancer incidence, based on median doses, ranged from less than 1 in 2000 for ASD occlusions to as high as 1 in 150 for valve replacements. For a reduced life expectancy of 50 years, estimated risks are lower by a factor of around 7. For conditions with especially poor survival (age 20 years), such as hypoplastic left heart syndrome, estimated cancer risks attributable to radiation were less than 1 in 20,000. Conclusions: Based on recent UK radiation dose levels, the risk of cancer following cardiac catheterizations is relatively low and strongly modified by survival and the type of procedure. The risk of breast cancer, especially following pulmonary artery angioplasty and valve replacements is the greatest concern.

Publication metadata

Author(s): Harbron RW, Chapple CL, O'Sullivan JJ, Best KE, Berrington-de-González A, Pearce MS

Publication type: Article

Publication status: Published

Journal: Heart

Year: 2017

Volume: 103

Pages: 341-346

Print publication date: 01/03/2017

Online publication date: 18/08/2016

Acceptance date: 27/07/2016

Date deposited: 30/08/2016

ISSN (print): 1355-6037

ISSN (electronic): 1468-201X

Publisher: BMJ Publishing Group


DOI: 10.1136/heartjnl-2016-309773


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