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Risk of Renal Cell Carcinoma among Kidney Transplant Recipients in the United States
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    Renal cell carcinoma (RCC) is a common malignancy following kidney transplantation. We describe RCC risk and examine RCC risk factors among US kidney recipients (1987-2010). The Transplant Cancer Match Study links the US transplant registry with 15 cancer registries. Standardized incidence ratios (SIRs) were used to compare RCC risk (overall and for clear cell [ccRCC] and papillary subtypes) to the general population. Associations with risk factors were assessed using Cox models. We identified 683 RCCs among 116 208 kidney recipients. RCC risk was substantially elevated compared with the general population (SIR 5.68, 95% confidence interval 5.27-6.13), especially for papillary RCC (SIR 13.3 versus 3.98 for ccRCC). Among kidney recipients, RCC risk was significantly elevated for blacks compared to whites (hazard ratio [HR] 1.50) and lower in females than males (HR 0.56). RCC risk increased with prolonged dialysis preceding transplantation (p-trend < 0.0001). Risk was variably associated for RCC subtypes with some medical conditions that were indications for transplantation: ccRCC risk was reduced with polycystic kidney disease (HR 0.54), and papillary RCC was increased with hypertensive nephrosclerosis (HR 2.02) and vascular diseases (HR 1.86). In conclusion, kidney recipients experience substantially elevated risk of RCC, especially for papillary RCC, and multiple factors contribute to these cancers.

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    U58 DP003931/DP/NCCDPHP CDC HHS/United States
    HHSN261201000037C/CA/NCI NIH HHS/United States
    N01PC35143/CA/NCI NIH HHS/United States
    U58 DP003883/DP/NCCDPHP CDC HHS/United States
    U58 DP003875/DP/NCCDPHP CDC HHS/United States
    P30 CA086862/CA/NCI NIH HHS/United States
    HHSN261201000036C/CA/NCI NIH HHS/United States
    U58 DP003879/DP/NCCDPHP CDC HHS/United States
    N01PC35137/CA/NCI NIH HHS/United States
    HHSN261201300071C/CA/NCI NIH HHS/United States
    U58 DP003920/DP/NCCDPHP CDC HHS/United States
    HHSN261201300011C/RC/CCR NIH HHS/United States
    U58 DP000807/DP/NCCDPHP CDC HHS/United States
    N01PC35142/CA/NCI NIH HHS/United States
    Z99 CA999999/Intramural NIH HHS/United States
    HHSN261201300021C/CA/NCI NIH HHS/United States
    HHSN261201000035I/CA/NCI NIH HHS/United States
    U58 DP000848/DP/NCCDPHP CDC HHS/United States
    HHSN261201000024C/CA/NCI NIH HHS/United States
    HHSN261201000034C/CA/NCI NIH HHS/United States
    U58 DP003921/DP/NCCDPHP CDC HHS/United States
    HHSN261201300011I/CA/NCI NIH HHS/United States
    U58 DP000832/DP/NCCDPHP CDC HHS/United States
    N01PC35139/CA/NCI NIH HHS/United States
    U58 DP000824/DP/NCCDPHP CDC HHS/United States
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