Research Program Manager, Early Career Research and Bioethics Graduate Student Unity Health Toronto Toronto, Ontario, Canada
Background: Phototherapy is the primary treatment for hyperbilirubinemia in neonates to prevent kernicterus. Although phototherapy is thought to pose minimal risk to infants with hyperbilirubinemia, in vitro and in vivo studies have demonstrated a possible association between phototherapy and cancer. Recent animal and cell culture studies have revealed concerns around light-induced DNA damage from phototherapy, raising questions around the potential cancer risk of phototherapy. Objective: The primary objective of this study was to determine if phototherapy is associated with increased cancer risk in children and young adults. Design/Methods: A systematic review and meta-analysis was conducted. Electronic databases including PubMed, Embase, and Cochrane Library were searched. Prospective and retrospective studies, case series, and review studies published between 1970 and 2021 were included. Neonates of all gestational ages and up to 28 days of life were included. This systematic review adheres to PRISMA guidelines and the search strategy was reviewed according to the Peer Review for Electronic Search Strategies guidelines. The meta-analysis used R programming and the odds ratios (ORs) with 95% confidence intervals (CIs) were estimated and pooled. Results: This systematic review yielded 16 studies and data from nine studies were analyzed. The data were extracted from studies published between 1995 and 2022. Follow up of study participants was up to 30 years. This meta-analysis showed that there was no significant increased risk of cancer from phototherapy exposure in infancy (OR 0.91; 95% CI 0.77, 1.08).
Conclusion(s): The results of this study are reassuring regarding the safety of phototherapy in infants with hyperbilirubinemia.
