Ren Lijuan, Feng Mei, Luo Yulan, Chen Yu
Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Cardiology. 2025;150(3):303-310. doi: 10.1159/000540443. Epub 2024 Jul 25.
There has been remarkable progress in both diagnosis and treatment of patients with congenital heart disease (CHD), with an increasing number of survivors. Whether patients with CHD are more likely to develop cancer is still a controversial issue. This study aimed to quantitatively estimate the association between patients with CHD and the risk of developing cancer through meta-analysis.
Web of Science, PubMed, and Embase databases were searched from inception to September 2023 to identify potentially relevant case-control studies and cohort studies that reported risk estimates and confidence intervals (CIs). RevMan software was used to analyze the pooled effect size and test for heterogeneity. The random effect and fixed effect models were applied to the study period. Egger's test was performed to examine publication bias.
We analyzed six studies, consisting of 2 case-control studies and 4 cohort studies comprising 276,124 participants. The overall pooled hazard risk for cancer in patients with CHD was 1.71 (95% CI: 1.28-2.28; p < 0.01), with significant heterogeneity (I2 = 97%, p < 0.01). The quantitative analysis of studies indicates that patients with CHD have an increased risk of developing cancer, even after adjusting for chromosomal disorders.
Our study highlights the importance of controlling modifiable factors in cancer prevention and emphasizes the need for health education for patients with CHD in primary care. Given the limited number of studies included in this analysis, further research is needed to accurately quantify the cancer risk of exposed versus unexposed CHD.
先天性心脏病（CHD）患者的诊断和治疗取得了显著进展，幸存者数量不断增加。CHD患者是否更易患癌症仍是一个有争议的问题。本研究旨在通过荟萃分析定量评估CHD患者与患癌风险之间的关联。
检索了Web of Science、PubMed和Embase数据库，时间跨度从建库至2023年9月，以确定报告风险估计值和置信区间（CIs）的潜在相关病例对照研究和队列研究。使用RevMan软件分析合并效应量并检验异质性。将随机效应模型和固定效应模型应用于研究期。进行Egger检验以检查发表偏倚。
我们分析了六项研究，包括两项病例对照研究和四项队列研究，共276,124名参与者。CHD患者患癌的总体合并风险比为1.71（95%CI：1.28 - 2.28；p < 0.01），存在显著异质性（I2 = 97%，p < 0.01）。研究的定量分析表明，即使在调整染色体疾病后，CHD患者患癌风险仍增加。
我们的研究强调了在癌症预防中控制可改变因素的重要性，并强调在初级保健中对CHD患者进行健康教育的必要性。鉴于本分析纳入的研究数量有限，需要进一步研究以准确量化暴露与未暴露CHD患者的癌症风险。
