Details:

Alternative Title:
Cancer
Personal Author:
Noone, Anne-Michelle ; Pfeiffer, Ruth M. ; Dorgan, Joanne F. ; Magder, Laurence S. ; Bromberg, Jonathan S. ; ... More +
Noone, Anne-Michelle ; Pfeiffer, Ruth M. ; Dorgan, Joanne F. ; Magder, Laurence S. ; Bromberg, Jonathan S. ; Lynch, Charles F. ; Morris, Cyllene ; Pawlish, Karen ; Engels, Eric A. Less -
Description:
Background:

Solid organ transplant recipients have an elevated risk of cancer. Quantifying deaths attributable to cancer can inform priorities to reduce cancer burden.

Methods:

Linked transplant and cancer registry data were used to identify incident cancers and deaths among solid organ transplant recipients in the United States (1987–2014). Population-attributable fractions (PAFs) of deaths due to cancer and corresponding cancer-attributable mortality rates were estimated using Cox models.

Results:

Among 221,962 transplant recipients, 15,012 developed cancer. Thirteen percent of deaths (PAF=13.2%) were attributable to cancer, corresponding to a cancer-attributable mortality rate of 516 per 100,000 person-years. Lung cancer was the largest contributor to mortality (PAF=3.1%), followed by non-Hodgkin lymphoma (NHL, PAF=1.9%), colorectal cancer (PAF=0.7%), and kidney cancer (PAF=0.5%). Cancer-attributable mortality rates increased with age at transplantation, reaching 1229 per 100,000 person-years among recipients 65+ years old. NHL was the largest contributor among children (PAF=4.1%) and lung cancer among 50+ year-olds (PAFs=3.7–4.3%). Heart recipients had the highest PAF (16.4%), but lung recipients had the highest cancer-attributable mortality rate (1241 per 100,000 person-years). Overall, mortality attributable to cancer increased steadily with longer time since transplant, reaching 15.7% of deaths (810 per 100,000 person-years) 10+ years post-transplant. Comparison of cancer-attributable mortality rates with specified causes of death indicated that some deaths recorded as other causes might instead be caused by cancer or its treatment.

Conclusions:

Cancer is a substantial cause of mortality among solid organ transplant recipients, with major contributions from lung cancer and NHL. Cancer-attributable mortality increases with age and time since transplant, so cancer deaths will become an increasing burden as recipients live longer.


Subject:
[+]
Adolescent
Adult
Aged
Child
Child, Preschool
Female
History, 20th Century
History, 21st Century
Humans
Infant
Infant, Newborn
Male
Middle Aged
Neoplasms
Organ Transplantation
Risk Factors
Transplant Recipients
Young Adult

Source:
Cancer. 125(15):2647-2655
Pubmed ID:
31034602
Pubmed Central ID:
PMC6625902
Document Type:
Journal Article
Funding:
HHSN261201000037C/CA/NCI NIH HHS/United States ; N01PC35143/CA/NCI NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States ; N01PC35137/CA/NCI NIH HHS/United States ; HHSN261201300071C/CA/NCI NIH HHS/United States ; ... More +
HHSN261201000037C/CA/NCI NIH HHS/United States ; N01PC35143/CA/NCI NIH HHS/United States ; U58 DP003875/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 ; U58 DP003933/DP/NCCDPHP CDC HHS/United States ; U58 DP000848/DP/NCCDPHP CDC HHS/United States ; HHSN261201300011I/CA/NCI NIH HHS/United States ; U58 DP000824/DP/NCCDPHP CDC HHS/United States ; U58 DP003883/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; P30 CA086862/CA/NCI NIH HHS/United States ; P30 AG028747/AG/NIA NIH HHS/United States ; HHSN261201000036C/CA/NCI NIH 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/ImNIH/Intramural NIH HHS/United States ; HHSN261201300021C/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003921/DP/NCCDPHP CDC HHS/United States ; N01PC35139/CA/NCI NIH HHS/United States ; HHSN261201800002C/CA/NCI NIH HHS/United States Less -
Genre:
Historical Article
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:47d0119c04f45c074ddd88bc7dae4bfc89f8c2b7bc673fdf794cfc0b186b2ad7
File Type:

Supporting Files

• 	NIHMS1020601-supplement-Supp_figS2.pptx	pptx
  	NIHMS1020601-supplement-supp_info.docx	docx
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  	nihms-1020601-f0002.jpg	jpeg
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  	nihms-1020601-f0003.jpg	jpeg
  	nihms-1020601.nxml	xml
  	NIHMS1020601-supplement-Supp_figS1.pptx	pptx

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