McLaughlin J R, Kreiger N, Sloan M P, Benson L N, Hilditch S, Clarke E A
Division of Epidemiology and Statistics, Ontario Cancer Treatment and Research Foundation, Toronto, Canada.
Int J Epidemiol. 1993 Aug;22(4):584-91. doi: 10.1093/ije/22.4.584.
This study aimed to determine whether cancer risk was elevated among patients exposed to radiation from diagnostic cardiac catheterization during childhood. The study cohort included 3915 children who underwent at least one cardiac catheterization at a major children's hospital in Toronto, Canada, between 1950 and 1965, were < or = 18 years at the time of the procedure, and were residents of Ontario. Follow-up of the cohort was done by linkage to the Ontario Cancer Registry up to 1986. A total of seven cancer deaths were observed (O), compared with 5.7 expected (E) based on provincial cancer rates (mortality ratio [O/E] = 1.2; 90% confidence interval [CI] : 0.6-2.3). In the analysis of cancer incidence, 13 cancers were detected, compared with 17.3 expected (O/E = 0.75; 90% CI : 0.4-1.2). These mortality and incidence ratios were not statistically significantly elevated. Detailed analyses were conducted according to age at exposure, age at diagnosis, sex, number of procedures, year of first catheterization, and latent period. Detected deviations in risk were confined to an early period of exposure, indicating that later practices of cardiac catheterization were not associated with increased risk. In general, there was no statistically significant excess risk of cancer among the cohort.
本研究旨在确定童年时期接受诊断性心导管插入术辐射的患者癌症风险是否升高。研究队列包括1950年至1965年间在加拿大多伦多一家大型儿童医院接受至少一次心导管插入术、手术时年龄≤18岁且为安大略省居民的3915名儿童。通过与安大略癌症登记处建立联系对该队列进行随访，直至1986年。共观察到7例癌症死亡（O），而根据省级癌症发病率预期为5.7例（E）（死亡率比[O/E]=1.2；90%置信区间[CI]：0.6 - 2.3）。在癌症发病率分析中，检测到13例癌症，而预期为17.3例（O/E = 0.75；90% CI：0.4 - 1.2）。这些死亡率和发病率比未出现统计学上的显著升高。根据暴露年龄、诊断年龄、性别、手术次数、首次心导管插入术年份和潜伏期进行了详细分析。检测到的风险偏差仅限于暴露早期，这表明后来的心导管插入术操作与风险增加无关。总体而言，该队列中癌症风险没有统计学上的显著增加。
