Cancer Incidence Among Canadian Kidney Transplant Recipients

• Published in: American journal of transplantation Vol. 7; no. 4; pp. 941 - 948
• Main Authors: Villeneuve, P. J., Schaubel, D. E., Fenton, S. S., Shepherd, F. A., Jiang, Y., Mao, Y.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2007; Blackwell
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Canada; Child; Databases, Factual; Epidemiology; Female; Follow-Up Studies; General aspects; Humans; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - surgery; Kidney Failure, Chronic - therapy; Kidney Transplantation - adverse effects; Kidney Transplantation - statistics & numerical data; Kidneys; Male; Medical sciences; Middle Aged; Neoplasms - epidemiology; Neoplasms - mortality; Nephrology. Urinary tract diseases; Postoperative Complications - epidemiology; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Renal Replacement Therapy - statistics & numerical data; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Tumors of the urinary system; Canada; North America; America; Kidney disease; Graft(material); Urinary system disease; Treatment; Surgery; Kidney cancer; Graft; Transplantation; Malignant tumor; Homotransplantation; Epidemiology; Incidence
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2007.01736.x

A number of studies have observed increased cancer incidence rates among individuals who have received renal transplants. Generally, however, these studies have been limited by relatively small sample sizes, short follow‐up intervals or focused on only one cancer site. We conducted a nationwide population‐based study of 11,155 patients who underwent kidney transplantation between 1981 and 1998. Incident cancers were identified up to December 31, 1999, through record linkage to the Canadian Cancer Registry. Patterns of cancer incidence in the cohort were compared to the Canadian general population using standardized incidence ratios (SIRs). We examined variations in risk according time since transplantation, year of transplantation and age at transplantation. In our patient population, we observed a total of 778 incident cancers versus 313.2 expected (SIR = 2.5, 95% CI = 2.3–2.7). Site‐specific SIRs were highest for cancer of the lip (SIR = 31.3, 95% CI = 23.5–40.8), non‐Hodgkin's lymphoma (NHL) (SIR = 8.8, 95% CI = 7.4–10.5), and kidney cancer (SIR = 7.3, 95% CI = 5.7–9.2). SIRs for NHL and cancer of the lip and kidney were highest and among transplant patients. This study confirms previous findings of increased risks of posttransplant cancer. Our findings underscore the need for increased vigilance among kidney transplant recipients for cancers at sites where there are no population‐based screening programs in place. This nationwide study of cancer risk in kidney transplant patients found a standardized incidence ratio of 2.5 compared to expected rates.