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Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Cohen S, Dauphin C, Filippo SD, Douchin S, Godart F, Guérin P, Helms P, Karsenty C, Lefort B, Mauran P, Ovaert C, Piéchaud JF, Thambo JB, Leuraud K, Bonnet D, Bernier MO, Rage E. Exposure to low-dose ionising radiation from cardiac catheterisation and risk of cancer: the COCCINELLE study cohort profile. BMJ Open 2021; 11:e048576. [PMID: 34344681 PMCID: PMC8336117 DOI: 10.1136/bmjopen-2020-048576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The COCCINELLE study is a nationwide retrospective French cohort set up to evaluate the risk of cancer in patients who undergone cardiac catheterisation (CC) procedures for diagnosis or treatment of congenital heart disease during childhood. PARTICIPANTS Children who undergone CC procedures from 1 January 2000 to 31 December 2013, before the age of 16 in one of the 15 paediatric cardiology departments which perform paediatric CC in mainland France were included. The follow-up started at the date of the first recorded CC procedure until the exit date, that is, the date of death, the date of first cancer diagnosis, the date of the 18th birthday or the 31 December 2015, whichever occurred first. The cohort was linked to the National Childhood Cancer Registry to identify patients diagnosed with cancer and with the French National Directory for the Identification of Natural Persons to retrieve the patients' vital status. FINDINGS TO DATE A total of 17 104 children were included in the cohort and followed for 110 335 person-years, with 22 227 CC procedures collected. Among the patients, 81.6% received only one procedure. Fifty-nine cancer cases were observed in the cohort. Standardised incidence ratios (SIRs) were increased for all-cancer (SIR=3.8, 95% CI: 2.9 to 4.9), leukaemia (SIR=3.3, 95% CI: 2.0 to 5.4), lymphoma (SIR=14.9, 95% CI: 9.9 to 22.5) and solid cancers excluding central nervous system (CNS) tumours (SIR=3.3, 95% CI: 2.0 to 5.5) compared with the general population. FUTURE PLANS Dose reconstruction is currently underway to estimate individual cumulative doses absorbed to relevant organs, including red bone marrow and brain for respectively haematologic disorders and CNS tumours risk estimation. A dose-response analysis will be conducted with consideration to confounding factors such as age at exposure, gender, predisposing factors to cancer and other sources of medical diagnostic low-dose ionising radiation.
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Affiliation(s)
- Kossi Dovene Abalo
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Sophie Malekzadeh-Milani
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Sébastien Hascoët
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Serge Dreuil
- PSE-SANTE/SER/UEM, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | | | - Sarah Cohen
- Paediatric and Congenital Cardiac Surgery Department, M3C Marie-Lannelongue Hospital, National Reference Centre, Groupe Hospitalier Saint-Joseph, Paris Saclay University, Plessis-Robinson, France
| | - Claire Dauphin
- Cardiology and Vascular Department, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | - Sylvie Di Filippo
- Paediatric and Congential Cardiology Department, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphanie Douchin
- Cardiopédiatrie, Hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, France, Grenoble, France
| | - François Godart
- Service de Cardiologie Infantile et Congénitale, Institut Cœur Poumon, Lille Cedex, Lille, France
| | - Patrice Guérin
- Clinique Cardiologique et des Maladies Vasculaires, CIC 1413, Institut du Thorax, Cardiopédiatrie, CHU Nantes, INSERM, Nantes Université, Nantes, France
| | - Pauline Helms
- Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France
| | - Clement Karsenty
- Pediatric and Congenital Cardiology, Children's Hospital and INSERM U1048, I2MC, Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Toulouse, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales, CHRU Tours, Tours, France
| | - Pierre Mauran
- Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, Reims Cedex, Reims, France
| | - Caroline Ovaert
- Cardiologie pédiatrique et congénitale, Timone enfants, AP-HM et INSERM 1251, Aix-Marseille Université, Marseille, France
| | - Jean-François Piéchaud
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques-Cartier, Massy, France
| | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Bordeaux, France
| | - Klervi Leuraud
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Damien Bonnet
- Department of Congenital and Pediatric Cardiology, Necker-Sick Children University Hospital, M3C-Necker, Université de Paris, Paris, France
| | - Marie-Odile Bernier
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
| | - Estelle Rage
- PSE-SANTE/SESANE/Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, Île-de-France, France
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