Risk of cancer associated with interventional cardiology during childhood: Setting up of a cohort study in France

*H. Baysson, Instit de Radioprotection et de Surete Nucleaire 
Y. Boudjemline, Centre de Reference Malformations Cardiaques Congenitales Complexes 
J. Petit, Centre Chirurgical Marie Lannelongue 
JL Rehel, Institut de Radioprotection et de Surete Nucleaire 
B. Aubert, Institut de Radioprotection et de Surete Nucleaire 
D. Laurier, Institut de Radioprotection et de Surete Nucleaire 
D. Bonnet, Centre de Reference Malformations Cardiaques Congenitales Complexes 
MO Bernier, Institut de Radioprotection et de Surete Nucleaire 

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Objective: Children with congenital heart disease frequently undergo interventional cardiology for diagnosis or intervention purposes. These procedures are known to give higher radiation doses to patients than other procedures in diagnostic radiology. Since children are particularly sensitive to the carcinogenic effects of ionizing radiation, a cohort study is being launched in France .in order to evaluate leukaemia and cancer risks among this specific population. Methods: The study population will include all children who underwent at least one interventional cardiology procedure since 2000, who were under 10 years old and were permanent residents in France Considering the period 2000-2013, almost 8,000 children could be included. Cohort follow up will be done through linkage with the French paediatric cancer registries which record all childhood leukaemia and cancers in France since 1990 and 2000, respectively. The radiation exposure will be estimated retrospectively for each child included in the cohort. Results: The French National reference Centre for Complex Congenital Cardiac defects (Necker Hospital, Paris) and the surgical centre Marie Lannelongue (Le Plessis-Robinson), which treated most of the children in France, already agreed to participate and confirmed the possibility to retrieve individual clinical and dosimetric data for the children involved. Up to now, 4500 children have been already included in the cohort but the recruitment is still ongoing for these two centres and will be then extended at the national level. On average, each child has undergone 1.3 interventional cardiology procedures, for a total of over 5,000 procedures. Nearly half of them were performed during the first year of life of the children involved. Conclusion: This French cohort study is designed to provide further knowledge on the potential cancer risk associated with paediatric interventional cardiology. It will also provide new information on typical levels of doses for paediatric interventional cardiology procedures in France.