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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v12.i4.50
8 pages

Cancer Risk Among Pacemaker Recipients in Denmark, 1982–1996

Loren Lipworth
International Epidemiology Institute, Rockville, Maryland; Department of Medicine, Vanderbilt University Medical Center and Vanderbilt—Ingram Cancer Center, Nashville, Tennessee
Christoffer Johansen
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
Per Arnsbo
Danish Pacemaker and ICD Register, Department of Cardiology, Odense University Hospital, Denmark
Mogens Moller
Danish Pacemaker and ICD Register, Department of Cardiology, Odense University Hospital, Denmark
Joseph K. McLaughlin
Professor of Medicine, Vanderbilt Medical School, President, International Epidemiology Institute, 1455 Research Blvd., Suite 550, Rockville, Maryland, 20850-3127, USA
Jorgen H. Olsen
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; and Department of Medicine, Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA

ABSTRACT

To address concerns about the potential carcinogenicity of pacemakers, we launched the first epidemiologic study of cancer incidence among pacemaker recipients. A nationwide cohort of 16,357 pacemaker recipients in Denmark from 1982 through 1996 was identified. The Danish Cancer Registry was used to identify all incident cancers within the cohort, with almost 75,000 person-years of observation. The cohort had a slight excess of cancer overall (SIR = 1.19, 95% confidence interval [95% CI, 1.1–1.2]). This was largely caused by an elevated SIR for multiple myeloma among men (SIR = 1.78, 95% CI, 1.1–2.8), which increased to 2.60 (95% CI, 0.9–5.7) 5–9 years after implantation, and to a similarly increased SIR for kidney cancer among women (SIR = 2.05, 95% CI, 1.3–3.0), which increased to 3.39 (95% CI, 1.6–6.2) after a latency period of 5–9 years. An excess of urinary bladder cancer was also seen after 10 years. No excess risk was observed for breast cancer or sarcomas, although the SIRs for sarcomas tended to increase over time, based on small numbers. Our results are largely reassuring but, as pacemakers become more common and are implanted at earlier ages and as survival following implantation improves, the excesses of bladder cancer, multiple myeloma among men, and kidney cancer among women with long-term followup warrant further investigation.