Grant: Operating Grant: Secondary Data Analysis for Cancer Prevention and Control

Over the past 4 decades, infants previously known as "blue babies" have become one of the fastest growing population with chronic lifelong diseases. There are over 250,000 patients with congenital heart disease (CHD) in Canada. They require life-long care with numerous cardiac procedures to diagnose and treat their conditions. They are subject to ionization radiation that procedures emit. We recently showed that adults with CHD have increased risk of cancer due to such radiation exposures. With this study, we want to know if the cancer risk starts to increase in childhood. We will measure life-time use of cardiac procedures and cancer incidence. We will use the Quebec CHD database for data on CHD children from Quebec, the Canadian Discharge Abstract Database for data on CHD children from the rest of Canada, and the Canadian Cancer Registry for cancer incidence in Canada's non-CHD children. These data will allow us to compare cancer diagnoses in those with and without CHD. By correlating cancer incidence with radiation doses from the procedures we will be able to determine the risk of cancer in CHD children and examine the risk predictors. The results of the proposed study will direct future work towards preventing cancer incidence. There are alternatives to procedures that emit low-dose radiation. If we document the increased risk of cancer in CHD children related to these procedures, we will begin to plan a different kind of health care delivery with safer cardiac procedures to prevent cancer complications and death. We will also recommend radiation surveillance in CHD patients where no regulation currently exists. Patients with numerous procedures should be informed of the potential risks of cancer and discuss alternative tests with their doctors. With this study, we will provide patients, doctors and governments with accurate information to justify the clinical need for repeated procedures and policy recommendations.