Gynecologic cancers and solid organ transplantation

• Published in: American journal of transplantation Vol. 19; no. 5; pp. 1266 - 1277
• Main Authors: Liao, John B., Fisher, Cynthia E., Madeleine, Margaret M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.05.2019
• Subjects: cancer/malignancy/neoplasia: risk factors; Cervical cancer; Cervix; Clinical decision making; clinical research/practice; Epidemiology; Female; Genital Neoplasms, Female - complications; Genital Neoplasms, Female - epidemiology; guidelines; hematology/oncology; Humans; Hysterectomy; Immunosuppressive Agents - adverse effects; Malignancy; Neoplasm Recurrence, Local; obstetrics and gynecology; Organ Transplantation - adverse effects; organ transplantation in general; Ovarian cancer; Papillomavirus Infections - complications; Papillomavirus Infections - epidemiology; Risk; Risk Factors; Tissue Donors; Transplantation; Transplants & implants; Treatment Outcome; Uterine cancer; Uterus; Uterus - transplantation; Vagina; hematology/oncology; organ transplantation in general; clinical research/practice; obstetrics and gynecology; cancer/malignancy/neoplasia: risk factors; guidelines; clinical decision-making
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/ajt.15292

Solid organ transplant (SOT) recipients have an approximately 2‐fold greater risk of developing and dying from a malignancy compared to the general population. Among the gynecologic cancers, including uterine, cervical, vaginal, vulvar, and ovarian, the HPV‐related cancers are known to increase among women posttransplant compared to women in the general population, but less is known about the risk of uterine and ovarian cancers. This review provides an overview of the epidemiology of gynecologic cancers after solid organ transplantation, as well as the pathophysiology, management, and specific risk factors associated with these cancers. Closer surveillance for cervical cancers is warranted and larger studies are needed to assess whether and how uterine and ovarian cancers are associated with excess incidence and mortality. Such studies may lead to improvements in screening, prevention, and treatment before and after transplantation. The authors provide an overview of gynecologic cancers as they relate to solid organ transplantation and include recommendations for prevention and surveillance.