Risk of Hepatobiliary Cancer After Solid Organ Transplant in the United States

Details

• Alternative Title:
  Clin Gastroenterol Hepatol
• Personal Author:
  Koshiol, Jill ; Pawlish, Karen ; Goodman, Marc T. ; McGlynn, Katherine A. ; Engels, Eric A.
• Description:
  BACKGROUND & AIMS
  
  Studies of liver cancer risk in recipients of solid organ transplants have generally been small, yielding mixed results, and little is known about biliary tract cancers among transplant recipients.
  
  METHODS
  
  We identified incident hepatobiliary cancers among 201,549 US recipients of solid organs, from 1987 through 2008, by linking data from the US transplant registry with 15 cancer registries. We calculated standardized incidence ratios (SIRs), comparing risk relative to the general population. We also calculated incidence rate ratios (RRs), comparing risk for hepatocellular carcinoma (HCC) and total (intrahepatic and extrahepatic) cholangiocarcinoma among subgroups of recipients.
  
  RESULTS
  
  Of transplant recipients, 165 developed hepatobiliary cancers (SIR, 1.2; 95% confidence interval [CI], 1.0–1.4). HCC risk was increased among liver recipients (SIR, 1.5; 95% CI, 1.0–2.2), especially 5 or more y after transplant (SIR, 1.8; 95% CI, 1.0–3.0). Cholangiocarcinoma was increased among liver (SIR, 2.9; 95% CI,1.6–4.8) and kidney recipients (SIR, 2.1; 95% CI, 1.3–3.1). HCC was associated with hepatitis B virus (RR, 3.2; 95% CI, 1.3–6.9), hepatitis C virus (RR, 10; 95% CI, 5.9–16.9), and non-insulin-dependent diabetes (RR, 2.5; 95% CI, 1.2–4.8). Cholangiocarcinoma was associated with azathioprine maintenance therapy (RR, 2.0; 95% CI, 1.1–3.7). Among liver recipients, primary sclerosing cholangitis (PSC) was associated with increased risk of cholangiocarcinoma, compared to the general population (SIR, 21; 95% CI, 8.2–42) and compared to liver recipients without PSC (RR, 12.3; 95% CI, 4.1–36.4).
  
  CONCLUSIONS
  
  Risks for liver and biliary tract cancer are increased among organ transplant recipients. Risk factors for these cancers include medical conditions and medications taken by recipients.
  
  
• Keywords:
  Adolescent Adult Aged Aged, 80 And Over Biliary Tract Neoplasms Child Child, Preschool Epidemiology Female HBV HCV Humans Incidence Infant Liver Disease Liver Neoplasms Male Middle Aged Neoplasms Risk Assessment Transplantation Transplants United States Young Adult

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• Source:
  Clin Gastroenterol Hepatol. 2013; 12(9):1541-9.e3
• Pubmed ID:
  24362053
• Pubmed Central ID:
  PMC4064001
• Document Type:
  Journal Article
• Funding:
  U58 DP000848-04/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201000036C/CA/NCI NIH HHSUnited States/ ; N01PC35137/CA/NCI NIH HHSUnited States/ ; U58 DP000807/DP/NCCDPHP CDC HHSUnited States/ ; 1U58 DP000807-01/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; 5U58DP003875-01/DP/NCCDPHP CDC HHSUnited States/ ; 1US58/DP0039311-01/DP/NCCDPHP CDC HHSUnited States/ ; 5U58DP000824-04/DP/NCCDPHP CDC HHSUnited States/ ; N01-PC-35142/PC/NCI NIH HHSUnited States/ ; HHSN261201000037C/CA/NCI NIH HHSUnited States/ ; HHSN261201000027C/CA/NCI NIH HHSUnited States/ ; U58DP0038789/DP/NCCDPHP CDC HHSUnited States/ ; N01PC35143/CA/NCI NIH HHSUnited States/ ; U58 DP000805/DP/NCCDPHP CDC HHSUnited States/ ; 5658DP000805-04/DP/NCCDPHP CDC HHSUnited States/ ; N01-PC-35137/PC/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; N01-PC-35139/PC/NCI NIH HHSUnited States/ ; N01-PC-2010-0027/PC/NCI NIH HHSUnited States/ ; U58DP000832/DP/NCCDPHP CDC HHSUnited States/ ; U58 DP003875/DP/NCCDPHP CDC HHSUnited States/ ; 5U58DP000812-03/DP/NCCDPHP CDC HHSUnited States/ ; N01PC35142/CA/NCI NIH HHSUnited States/ ; Z99 CA999999/ImNIH/Intramural NIH HHSUnited States/ ; U58 DP000848/DP/NCCDPHP CDC HHSUnited States/ ; U58 DP000812/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201000024C/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP000832/DP/NCCDPHP CDC HHSUnited States/ ; N01PC35139/CA/NCI NIH HHSUnited States/ ; HHSN261201000026C/CA/NCI NIH HHSUnited States/ ; N01-PC-35143/PC/NCI NIH HHSUnited States/ ; U58 DP000824/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  12
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3ce2e567e15572906f2ad2e19bc1a3efb755bb33026eb5e448604c4d5b6b87c9
• Download URL:
  https://stacks.cdc.gov/view/cdc/30005/cdc_30005_DS1.pdf
• File Type:
  [PDF - 407.82 KB ]