Cumulative incidence of cancer after solid organ transplantation

Erin C. Hall, Ruth M. Pfeiffer, Dorry L. Segev, Eric A. Engels

Research output: Contribution to journalArticlepeer-review

Abstract

background Solid organ transplantation recipients have elevated cancer incidence. Estimates of absolute cancer risk after transplantation can inform prevention and screening. methods 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. results 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. conclusions Subgroups of transplantation recipients have a high absolute risk of some cancers and may benefit from targeted prevention or screening. Cancer 2013;119:2300-2308. © 2013 American Cancer Society. The cumulative incidence of 6 preventable or screen-detectable cancers after transplantation is estimated using population-based data on 164,156 US transplantation recipients. High-risk subgroups are identified that may benefit from targeted screening or prevention, including thoracic organ recipients at the extremes of age for non-Hodgkin lymphoma, older thoracic organ recipients for lung cancer, and kidney recipients aged >35 years for kidney cancer.

Original languageEnglish (US)
Pages (from-to)2300-2308
Number of pages9
JournalCancer
Volume119
Issue number12
DOIs
StatePublished - Jun 15 2013

Keywords

  • absolute risk
  • non-Hodgkin lymphoma
  • screening
  • transplantation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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