Risk of human papillomavirus-related cancers among kidney transplant recipients and patients receiving chronic dialysis--an observational cohort study

• Published in: BMC nephrology Vol. 14; no. 1; p. 137
• Main Authors: Skov Dalgaard, Lars, Fassel, Ulrik, Østergaard, Lars Jørgen, Jespersen, Bente, Schmeltz Søgaard, Ole, Jensen-Fangel, Søren
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.07.2013; BioMed Central
• Subjects: Adolescent; Adult; Aged; Anus Neoplasms - epidemiology; Anus Neoplasms - therapy; Cervical cancer; Cohort Studies; Complications and side effects; Denmark - epidemiology; Diagnosis; Female; Health aspects; Hemodialysis; Human papillomavirus; Humans; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - therapy; Kidney Failure, Chronic - virology; Kidney Transplantation - adverse effects; Kidneys; Male; Medicare; Middle Aged; Nephrology; Organ transplant recipients; Papillomaviridae; Papillomavirus infections; Renal Dialysis - adverse effects; Risk Factors; Studies; Transplantation; Transplants & implants; Vaginal Neoplasms - epidemiology; Vaginal Neoplasms - therapy; Vulvar Neoplasms - epidemiology; Vulvar Neoplasms - therapy; Young Adult; Denmark
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/1471-2369-14-137

Individuals with end-stage renal disease (ESRD) have excess risk of various cancer types. However, the total burden of human papillomavirus-related cancers remains unknown. We performed a nationwide observational cohort study during 1994-2010.For each person with ESRD, we sampled 19 population controls (without ESRD) matched on age, gender and municipality. Participants were followed until first diagnosis of human papillomavirus-related cancer, death, emigration, or 31 December 2010, whichever came first.Human papillomavirus-related cancers were extracted from Danish medical administrative databases. We considered cancers of the cervix, vulva, vagina, penis, anus, and subsets of head and neck cancers as human papillomavirus-related. We calculated incidence rates of human papillomavirus-related cancer and used Poisson regression to identify risk factors for human papillomavirus-related cancer. Among 12,293 persons with ESRD and 229,524 population controls we identified 62 and 798 human papillomavirus-related cancers, respectively. Incidence rates of human papillomavirus-related- cancer were 102 per 100,000 person-years (95% confidence interval [CI]; 79.5-131) among persons with ESRD and 40.8 per 100,000 person-years (95% CI; 38.1-43.7) among population controls. ESRD patients had 4.54 (95% CI, 2.48-8.31) fold increased risk of anal cancer and 5.81 fold (95% CI; 3.36-10.1) increased risk of vulvovaginal cancer. Adjusted for age, comorbidity, and sex, ESRD patients had 2.41 (95% CI; 1.83-3.16) fold increased risk of any human papillomavirus-related cancer compared with population controls. Compared with dialysis patients renal transplant recipients had an age-adjusted non-significant 1.53 (95% CI, 0.91-2.58) fold higher risk of human papillomavirus-related cancer. Persons with ESRD have excess risk of potentially vaccine-preventable human papillomavirus-related cancers.