Institute of Health & Society - Child Health - Newcastle University

Children represent a known radiation sensitive group and have a longer period for radiation induced effects to appear.With survival of individuals born with congenital heart defects reported to exceed 80% (aged 20 years), large scale studies of the outcomes in these patients are now possible.

The proposal is to establish a registry, for long-term follow up, of children and young adults who underwent fluoroscopic cardiology procedures and assess their cancer risk in relation to the estimated radiation doses they received. Leukaemia will be the main outcome initially as it has a relatively short latency and tends to occur at younger ages. The cohort will be flagged at the NHS Central Register (NHSCR) and Northern Ireland equivalents for cancer and mortality followup.  This will allow future analyses to consider rarer diseases thought to be associated with radiation exposure (e.g. brain and breast cancers). Based on pilot study numbers, the initial cohort of patients, aged under 22 years, is estimated at 15,000.

Electronic patient records will be obtained from Radiology and Cardiology Departments in UK hospitals and matched with those on the NHSCR and NI registers. Any cancers and deaths will be notified. Patients will also be matched with congenital anomaly registers to identify the heart defects involved and infants with Down’s syndrome. This will allow possible confounding to be investigated. Crossmatching records with an existing CT scan study will allow additional radiation exposures from this source to also be taken into account.

The Chief Investigator is Dr Mark Pearce.