Grant: Project Grant

There is increasing concern with the risk of cancer in patients with congenital heart disease (CHD). Benefitting from advanced heart testing and treatments, patients born with CHD now become thriving adults. However, there is an increased risk for cancer due to, the even very small doses of radiation that comes from advanced testing such as scans and catheter-based procedures of the heart and chest that are used repeatedly. To help protect care-providers and patients from cancer, the guideline "As low as reasonably achievable" (ALARA) was published in the U.S in 2004 and in Canada in 2013. However, nearly twenty years later we don't know if ALARA has had an impact on how we manage patients with heart disease. Has the radiation exposure from procedures in patients been reduced? So far, no studies has answered this question. We therefore propose to evaluate if the ALARA policy has resulted in decreased exposure to radiation-emitting procedures in adult patients with CHD in Canada over the last two decades and project the exposure rate of radiation-emitting procedures for the next decade. This is important because safer alternatives to radiation-emitting procedures are available but are more costly. It is also important because we can propose that patients wear badges to record radiation as health care providers do. We have created the first pan-Canadian database of CHD that includes 499,495 patients born with heart defects followed for a maximum of 35 years from 1983 to 2017 and will update it to 2022, ideally suited to answer the research question of this study. Working in collaboration with patients, decision makers and professional societies we will disseminate evidence to physicians to promote the measures for reducing the radiation exposure and cancer risk in patients with CHD. The study findings from this project will help improve prevention for thousands of patients with CHD who now survive into adulthood but face comorbidities including cancer.