Risk of Cancer in Patients with Congenital Heart Disease: A Systematic Review and Meta-Analysis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Pub Date : 2024-07-25 DOI:10.1159/000540443

Lijuan Ren, Mei Feng, Yulan Luo, Yu Chen

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Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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先天性心脏病患者罹患癌症的风险：系统回顾和荟萃分析。

导言：先天性心脏病（CHD）患者的诊断和治疗都取得了长足的进步，存活人数不断增加。先天性心脏病患者是否更容易罹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估计先天性心脏病患者与癌症发病风险之间的关系。方法检索从开始到 2023 年 9 月的 Web of Science、PubMed 和 Embase 数据库，以确定报告了风险估计值和置信区间的潜在相关病例对照研究和队列研究。使用RevMan软件分析汇总效应大小并检验异质性。研究期间采用随机效应和固定效应模型。进行了 Egger 检验以检测发表偏倚。结果我们分析了六项研究，其中包括两项病例对照研究和四项队列研究，共有 276,124 人参与。心脏病患者罹患癌症的总危险风险为 1.71（95% CI：1.28-2.28；P<0.01），存在显著的异质性（I2=97%，P<0.01）。研究的定量分析表明，即使对染色体疾病进行调整，患有先天性心脏病的患者罹患癌症的风险也会增加。结论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，并强调了在初级保健中对冠心病患者进行健康教育的必要性。鉴于本分析中包含的研究数量有限，因此需要进一步研究，以准确量化暴露与未暴露心脏病患者的癌症风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.