A large epidemiologic study carried out by the National Cancer Institute (NCI), in collaboration with the ACC and other medical societies, explores the risk of cancer death among physicians who perform fluoroscopically-guided (FG) procedures. The study should provide helpful data to ascertain causes and risk of death in physicians performing these procedures.

FG procedures, which are performed by radiologists and other physicians, can result in substantial cumulative radiation exposures to both physicians and patients. While the number of FG procedures performed each year in the U.S. has increased significantly over the past three decades, the number of radiologists and practitioners performing these procedures has not risen proportionately.

In the initial phase of the study, NCI investigators worked with the ACC, other professional medical societies, and the American Medical Association to identify all physicians in the U.S. who met specific criteria (i.e. trained in sub-specialties where interventional procedures are part of routine practice, U.S. resident, and known vital status). In total they found about 41,000 practitioners who met these criteria—this study population of interest is considered “exposed” due to their use of FG procedures in their practice. The investigators then searched the National Death Index to ascertain the number of deaths in this population—about 3,400 between 1979 and 2008—and to determine the cause of death. The ACC contributed approximately 24,000 physicians to the study and among this group there were about 1,300 deaths.

Next the investigators will compare death outcomes for all exposed physicians with about 170,000 unexposed physicians—those who have a low probability of occupational radiation exposures, including psychiatrists and general practitioners.

According to the investigators, “this study of cancer risk among radiation-exposed workers will provide useful information that should contribute to knowledge about health effects of low-dose radiation exposures. Much of the understanding of radiation-related cancer and other disease risks has been derived from studies of Japanese atomic bomb survivors and patients treated with radiotherapy for benign or malignant conditions.”

“The ACC is excited to be a part of this important study,” said ACC President John Gordon Harold, MD, MACC. “The results will provide invaluable information on the real risks associated with low-dose radiation exposure that could improve the health and safety of physicians performing these procedures.”

Limiting radiation exposure is important for all patients, but it is particularly important for congenital heart patients who are exposed to radiation throughout the entirety of their lives. Next month, the ACC is introducing a new quality initiative, Reducing Radiation Risk. This program aims to reduce radiation exposure for IMPACT Registry® patients undergoing congenital cardiac catheterization procedures. The program is designed to cultivate a culture of quality improvement in pediatric catheter programs, and to support physician engagement in quality improvement activities. Reducing Radiation Risk has been approved by the American Board of Pediatrics for Maintenance of Certification credits. To learn more about this new ACC initiative, contact ncdr@acc.org. The IMPACT Registry is part of the ACC’s NCDR suite of data registries helping hospitals and private practices measure and improve the quality of cardiovascular care they provide. Visit NCDR.com/Impact to learn more about the registry.