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Implantable cardioverter-defibrillators and subsequent cancer risk: a nationwide population-based cohort study.
Europace 2015; 17(6):902-8E

Abstract

AIMS

Despite increasing use of implantable cardioverter-defibrillators (ICDs) and reports linking selected bio-implants with cancer, the cancer risk associated with implanted ICDs remains unknown. The objective of our study was to examine cancer risk among ICD recipients.

METHODS AND RESULTS

We conducted a population-based cohort study using medical registries covering the entire Danish population. We identified all first-time ICD recipients during the period of 2000-11 and determined their subsequent cancer incidence. Standardized incidence ratios (SIRs) were computed by comparing observed cancer incidence in the ICD cohort with expected cancer incidence based on national incidence rates according to age, sex, and year of diagnosis. A total of 6723 ICD recipients were followed for up to 12 years (median 2.8 years) and contributed a total of 23 254 person-years of follow-up. Compared with the general population, ICD recipients had a slightly elevated overall risk of cancer [SIR = 1.1 (95% confidence interval (CI): 1.0-1.2)]. This was driven by the cancer risk among patients with ischaemic heart disease (IHD) [SIR = 1.1 (95% CI: 1.0-1.3)], which, as expected, was particularly elevated for tobacco-related cancers [SIR = 1.4 (95% CI: 1.2-1.6)]. Importantly, ICD recipients without IHD were not at increased cancer risk [SIR = 1.0 (95% CI: 0.8-1.3)].

CONCLUSION

This nationwide population-based cohort study with up to 12-year follow-up did not indicate a causal relation between ICD implantation and cancer. However, more follow-up data are needed to entirely rule out risks for individual cancer types.

Authors+Show Affiliations

Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark susapese@rm.dk.Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark.Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark.Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25840286

Citation

Pedersen, Susanne Bendesgaard, et al. "Implantable Cardioverter-defibrillators and Subsequent Cancer Risk: a Nationwide Population-based Cohort Study." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 17, no. 6, 2015, pp. 902-8.
Pedersen SB, Nielsen JC, Bøtker HE, et al. Implantable cardioverter-defibrillators and subsequent cancer risk: a nationwide population-based cohort study. Europace. 2015;17(6):902-8.
Pedersen, S. B., Nielsen, J. C., Bøtker, H. E., Farkas, D. K., Schmidt, M., & Sørensen, H. T. (2015). Implantable cardioverter-defibrillators and subsequent cancer risk: a nationwide population-based cohort study. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 17(6), pp. 902-8. doi:10.1093/europace/euv076.
Pedersen SB, et al. Implantable Cardioverter-defibrillators and Subsequent Cancer Risk: a Nationwide Population-based Cohort Study. Europace. 2015;17(6):902-8. PubMed PMID: 25840286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implantable cardioverter-defibrillators and subsequent cancer risk: a nationwide population-based cohort study. AU - Pedersen,Susanne Bendesgaard, AU - Nielsen,Jens Cosedis, AU - Bøtker,Hans Erik, AU - Farkas,Dóra Körmendiné, AU - Schmidt,Morten, AU - Sørensen,Henrik Toft, Y1 - 2015/04/02/ PY - 2014/11/24/received PY - 2015/02/16/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2016/2/18/medline KW - Cancer KW - Cohort study KW - Epidemiology KW - Implantable cardioverter-defibrillators KW - Risk SP - 902 EP - 8 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 17 IS - 6 N2 - AIMS: Despite increasing use of implantable cardioverter-defibrillators (ICDs) and reports linking selected bio-implants with cancer, the cancer risk associated with implanted ICDs remains unknown. The objective of our study was to examine cancer risk among ICD recipients. METHODS AND RESULTS: We conducted a population-based cohort study using medical registries covering the entire Danish population. We identified all first-time ICD recipients during the period of 2000-11 and determined their subsequent cancer incidence. Standardized incidence ratios (SIRs) were computed by comparing observed cancer incidence in the ICD cohort with expected cancer incidence based on national incidence rates according to age, sex, and year of diagnosis. A total of 6723 ICD recipients were followed for up to 12 years (median 2.8 years) and contributed a total of 23 254 person-years of follow-up. Compared with the general population, ICD recipients had a slightly elevated overall risk of cancer [SIR = 1.1 (95% confidence interval (CI): 1.0-1.2)]. This was driven by the cancer risk among patients with ischaemic heart disease (IHD) [SIR = 1.1 (95% CI: 1.0-1.3)], which, as expected, was particularly elevated for tobacco-related cancers [SIR = 1.4 (95% CI: 1.2-1.6)]. Importantly, ICD recipients without IHD were not at increased cancer risk [SIR = 1.0 (95% CI: 0.8-1.3)]. CONCLUSION: This nationwide population-based cohort study with up to 12-year follow-up did not indicate a causal relation between ICD implantation and cancer. However, more follow-up data are needed to entirely rule out risks for individual cancer types. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/25840286/Implantable_cardioverter_defibrillators_and_subsequent_cancer_risk:_a_nationwide_population_based_cohort_study_ L2 - https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euv076 DB - PRIME DP - Unbound Medicine ER -