Cumulative Incidence of Cancer After Solid Organ Transplantation
Published Date:Apr 04 2013
Source:Cancer. 2013; 119(12):2300-2308.
Pubmed Central ID:PMC4241498
Funding:15-0351/PHS HHS/United States
1U58 DP000807-01/DP/NCCDPHP CDC HHS/United States
5658DP 000805-04/DP/NCCDPHP CDC HHS/United States
5U58/DP000808-05/DP/NCCDPHP CDC HHS/United States
5U58DP000812-03/DP/NCCDPHP CDC HHS/United States
5U58DP000817-05/DP/NCCDPHP CDC HHS/United States
5U58DP000824-04/DP/NCCDPHP CDC HHS/United States
HHSH234200537009C/PHS HHS/United States
HHSH250201000018C/PHS HHS/United States
HHSN261201000024C/PHS HHS/United States
HHSN261201000026C/PHS HHS/United States
HHSN261201000027C/PHS HHS/United States
HHSN261201000034C/PHS HHS/United States
HHSN261201000035C/PHS HHS/United States
HHSN261201000036C/PHS HHS/United States
N01-PC-2012-00,027/PC/NCI NIH HHS/United States
N01-PC-35,137/PC/NCI NIH HHS/United States
N01-PC-35,139/PC/NCI NIH HHS/United States
N01-PC-35,142/PC/NCI NIH HHS/United States
N01-PC-35,143/PC/NCI NIH HHS/United States
T32 CA126607/CA/NCI NIH HHS/United States
T32CA126607/CA/NCI NIH HHS/United States
U58 DP000848-04/DP/NCCDPHP CDC HHS/United States
U58DP000832/DP/NCCDPHP CDC HHS/United States
Z01 CP010150-08/Intramural NIH HHS/United States
Solid organ transplantation recipients have elevated cancer incidence. Estimates of absolute cancer risk after transplantation can inform prevention and screening.
The Transplant Cancer Match Study links the US transplantation registry with 14 state/regional cancer registries. The authors used nonparametric competing risk methods to estimate the cumulative incidence of cancer after transplantation for 2 periods (1987–1999 and 2000–2008). For recipients from 2000 to 2008, the 5-year cumulative incidence, stratified by organ, sex, and age at transplantation, was estimated for 6 preventable or screen-detectable cancers. For comparison, the 5-year cumulative incidence was calculated for the same cancers in the general population at representative ages using Surveillance, Epidemiology, and End Results data.
Among 164,156 recipients, 8520 incident cancers were identified. The absolute cancer risk was slightly higher for recipients during the period from 2000 to 2008 than during the period from 1987 to 1999 (5-year cumulative incidence: 4.4% vs 4.2%; P =.006); this difference arose from the decreasing risk of competing events (5-year cumulative incidence of death, graft failure, or retransplantation: 26.6% vs 31.9%; P <.001). From 2000 to 2008, the 5-year cumulative incidence of non-Hodgkin lymphoma was highest at extremes of age, especially in thoracic organ recipients (ages 0–34 years: range, 1.74%–3.28%; aged >50 years; range, 0.36%–2.22%). For recipients aged >50 years, the 5-year cumulative incidence was higher for colorectal cancer (range, 0.33%–1.94%) than for the general population at the recommended screening age (aged 50 years: range, 0.25%–0.33%). For recipients aged >50 years, the 5-year cumulative incidence was high for lung cancer among thoracic organ recipients (range, 1.16%–3.87%) and for kidney cancer among kidney recipients (range, 0.53%–0.84%). The 5-year cumulative incidence for prostate cancer and breast cancer was similar or lower in transplantation recipients than at the recommended ages of screening in the general population.
Subgroups of transplantation recipients have a high absolute risk of some cancers and may benefit from targeted prevention or screening.
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