Non-Breast Implantable Medical Devices and Associated Malignancies: A Systematic Review

Area of Science:

• Medical devices
• Oncology
• Public health

Background:

• Innovation in healthcare has led to widespread use of implantable medical devices (IMDs).
• Concerns exist regarding malignancies associated with non-breast IMDs, prompting investigation into their prevalence and characteristics.
• Existing knowledge primarily focuses on breast implant-associated malignancies.

Purpose of the Study:

• To conduct a comprehensive systematic review examining the prevalence and characteristics of malignancies associated with non-breast IMDs.
• To identify common malignancy types and their locations in relation to IMDs.
• To assess the overall oncologic risk posed by non-breast IMDs.

Main Methods:

• Systematic review following PRISMA guidelines, searching MEDLINE, Embase, and Cochrane Central Register.
• Inclusion of gray literature and references from existing systematic reviews and meta-analyses.
• Evaluation of risk of bias using JBI Critical Appraisal tools; 12,230 articles were initially reviewed, with 77 meeting inclusion criteria.

Main Results:

• A total of 616 cases of IMD-associated malignancies were identified across 77 studies.
• Malignancies were most frequently reported in the head and neck (88.1%), followed by the lower extremity (9.6%).
• Common types included squamous cell carcinoma (head and neck), sarcoma (lower extremity), and lymphoma (thorax).

Conclusions:

• The oncologic risk associated with non-breast implantable medical devices is generally low.
• Malignancy associated with IMDs should be considered in patient consent and when new symptoms arise near an implant.
• Further research is needed to elucidate the mechanisms of primary malignancies around IMDs and develop risk reduction strategies.