Risk of lung cancer in lung transplant recipients in the United States

Details

• Alternative Title:
  Am J Transplant
• Personal Author:
  Triplette, Matthew ; Crothers, Kristina ; Mahale, Parag ; Yanik, Elizabeth L. ; Valapour, Maryam ; Lynch, Charles F. ; Schabath, Matthew B. ; Castenson, David ; Engels, Eric A.
• Description:
  Lung transplant recipients have an increased risk of lung cancer that is poorly understood. Prior studies are largely descriptive and single-center, and have not examined risk factors or outcomes in this population. This registry-linkage study utilized matched transplant and cancer registry data from 17 US states/regions during 1987-2012. We used standardized incidence ratios (SIRs) to compare incidence with the general population, Poisson models to identify lung cancer risk factors, and Cox models to compare survival after diagnosis. Lung cancer risk was increased among lung recipients (SIR 4.8, 95% confidence interval [CI] 4.1-5.5). Those with single lung transplant had 13-fold (95% CI 11-15) increased risk in the native lung. Native lung cancer risk factors included age, prior smoking, time since transplant, and idiopathic pulmonary fibrosis. Compared with cases in the general population, lung cancers in recipients were more frequently localized stage (P = .02) and treated surgically (P = .05). However, recipients had higher all-cause (adjusted hazard ratio 1.90, 95% CI 1.52-2.37) and cancer-specific mortality (adjusted hazard ratio 1.67, 95% CI 1.28-2.18). In conclusion, lung cancer risk is increased after lung transplant, especially in the native lung of single lung recipients. Traditional risk factors are associated with lung cancer in these patients. Lung cancer survival is worse among lung recipients despite earlier diagnosis.
• Subjects:
  Adolescent Adult Aged Child Child, Preschool Female Humans Incidence Infant Infant, Newborn Lung Diseases Lung Neoplasms Lung Transplantation Male Middle Aged Poisson Distribution Proportional Hazards Models Registries Risk Factors Transplant Recipients Treatment Outcome Young Adult

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• Source:
  Am J Transplant. 19(5):1478-1490
• Pubmed ID:
  30565414
• Pubmed Central ID:
  PMC6872188
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHS/United States ; HHSN261201000037C/CA/NCI NIH HHS/United States ; N01PC35143/CA/NCI NIH HHS/United States ; UL1 TR001863/TR/NCATS 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 ; N01PC35142/CA/NCI NIH 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 ; N01PC35139/CA/NCI NIH HHS/United States ; U58 DP000824/DP/NCCDPHP CDC HHS/United States ; HHSN261201300019C/CA/NCI NIH HHS/United States ; U58 DP003883/DP/NCCDPHP CDC HHS/United States ; Intramural Research Program of the National Cancer Institute/International ; P30 CA086862/CA/NCI NIH HHS/United States ; HHSN261201000036C/CA/NCI NIH HHS/United States ; U58 DP003879/DP/NCCDPHP CDC HHS/United States ; HHSN261201300011C/RC/CCR NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; HHSN261201300021C/CA/NCI NIH HHS/United States ; T32 HL007287/HL/NHLBI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000035C/PC/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003921/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  19
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ef3785cd08bd6da5cdd1b851aef8b8a43ec07623348ac10d0512dcf4e3c9efbb
• Download URL:
  https://stacks.cdc.gov/view/cdc/83122/cdc_83122_DS1.pdf
• File Type:
  [PDF - 464.09 KB ]