Cancer Mortality Among Solid Organ Transplant Recipients in the United States During 1987–2018

Details

• Alternative Title:
  Transplantation
• Personal Author:
  Wang, Jeanny H. ; Pfeiffer, Ruth M. ; Musgrove, Donnie ; Castenson, David ; Fredrickson, Mark ; Miller, Jon ; Gonsalves, Lou ; Hsieh, Mei-Chin ; Lynch, Charles F. ; Zeng, Yun ; Yu, Kelly J. ; Hart, Allyson ; Israni, Ajay K. ; Snyder, Jon J. ; Engels, Eric A.
• Description:
  Background:
  
  Solid organ transplant recipients (i.e., “recipients”) have elevated cancer risk and reduced survival after cancer diagnosis. Evaluation of cancer mortality among recipients can facilitate improved outcomes from cancers arising before and after transplantation.
  
  Methods:
  
  We linked the United States transplant registry to the National Death Index to ascertain causes for 126 474 deaths among 671 127 recipients (1987–2018). We used Poisson regression to identify risk factors for cancer mortality and calculated standardized mortality ratios (SMRs) to compare cancer mortality in recipients to the general population. Cancer deaths verified with a corresponding cancer diagnosis from a cancer registry were classified as death from pretransplant or posttransplant cancers.
  
  Results:
  
  Thirteen percent of deaths were caused by cancer. Deaths from lung cancer, liver cancer, and non-Hodgkin lymphoma (NHL) were most common. Heart and lung recipients had the highest mortality for lung cancer and NHL, while liver cancer mortality was highest among liver recipients. Compared with the general population, cancer mortality was elevated overall (SMR 2.33, 95% confidence interval 2.29–2.37) and for most cancer sites, with large increases from non-melanoma skin cancer (23.4, 21.5–25.5), NHL (5.17, 4.87–5.50), kidney cancer (3.40, 3.10–3.72), melanoma (3.27, 2.91–3.68), and (among liver recipients) liver cancer (26.0, 25.0–27.1). Most cancer deaths (93.3%) were associated with posttransplant cancer diagnoses, excluding liver cancer deaths in liver recipients (of which all deaths were from pretransplant diagnoses).
  
  Conclusions:
  
  Improved posttransplant prevention and/or screening for lung cancer, NHL, and skin cancers, and management of liver recipients with prior liver cancer, may reduce cancer mortality among recipients.
  
  
• Subjects:
  Humans Incidence Kidney Neoplasms Liver Neoplasms Lung Neoplasms Organ Transplantation Registries Risk Factors Skin Neoplasms Transplant Recipients United States

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• Source:
  Transplantation. 107(11):2433-2442
• Pubmed ID:
  37291711
• Pubmed Central ID:
  PMC10615843
• Document Type:
  Journal Article
• Funding:
  75N99021D00009/OF/ORFDO NIH HHSUnited States/ ; HHSN261201000037C/CA/NCI NIH HHSUnited States/ ; N01PC35143/CA/NCI NIH HHSUnited States/ ; Z01 CP010150/ImNIH/Intramural NIH HHSUnited States/ ; U58 DP003875/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800013C/CA/NCI NIH HHSUnited States/ ; 75N96021D00006/ES/NIEHS NIH HHSUnited States/ ; 75N96021D00009/ES/NIEHS NIH HHSUnited States/ ; 75N98021D00006/NH/NIH HHSUnited States/ ; U58 DP000807/DP/NCCDPHP CDC HHSUnited States/ ; NU58DP007131/CC/CDC HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; HHSN261201800004C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; P30 CA086862/CA/NCI NIH HHSUnited States/ ; HHSN261201000036C/CA/NCI NIH HHSUnited States/ ; N01PC35137/CA/NCI NIH HHSUnited States/ ; HHSN261201800014C/CA/NCI NIH HHSUnited States/ ; HHSN261201800016C/CA/NCI NIH HHSUnited States/ ; HHSN261201800016I/CA/NCI NIH HHSUnited States/ ; 27307C0011/ES/NIEHS NIH HHSUnited States/ ; U58 DP003933/DP/NCCDPHP CDC HHSUnited States/ ; U58 DP000848/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800012C/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP003921/DP/NCCDPHP CDC HHSUnited States/ ; 75N92021D00006/HL/NHLBI NIH HHSUnited States/ ; 27398C0011/ES/NIEHS NIH HHSUnited States/ ; HHSN261201800014I/CA/NCI NIH HHSUnited States/ ; 27305C0011/ES/NIEHS NIH HHSUnited States/ ; HHSN261201800012I/CA/NCI NIH HHSUnited States/ ; N01PC35139/CA/NCI NIH HHSUnited States/ ; HHSN261201800002C/CA/NCI NIH HHSUnited States/ ; HHSN261201800013I/CA/NCI NIH HHSUnited States/ ; HHSN261201800006I/CA/NCI NIH HHSUnited States/ ; U58 DP000824/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800002B/CA/NCI NIH HHSUnited States/ ; 75N97021D00006/LM/NLM NIH HHSUnited States/ ; 75N92021D00009/HL/NHLBI NIH HHSUnited States/ ; 75N90021D00009/HL/NHLBI NIH HHSUnited States/
• Volume:
  107
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:439985f4ee53ac5c29014975d25c5bb59d3e44832aee1dc1a8afd01716f10f9f0634b22be14cd9fc728326be35d12fd6dd216650e071cef8d9e21fa1b1571eb8
• Download URL:
  https://stacks.cdc.gov/view/cdc/134767/cdc_134767_DS1.pdf
• File Type:
  [PDF - 434.24 KB ]