Cancer risk doubles for organ-transplant recipients

Compared with the general population, recipients of a kidney, liver, heart, or lung transplant have twice as great a risk for diverse infection-related and unrelated cancers, revealed a recent analysis of US transplant and cancer registries.

Recipients of solid-organ transplants are known to have elevated cancer risk due to immunosuppression and oncogenic viral infections. To describe the overall pattern of cancer following solid-organ transplantation, investigators culled data on 175,732 solid-organ transplants from the US Scientific Registry of Transplant Recipients (1987-2008) and 13 state and regional cancer registries.

The most common transplanted organs were kidney (58.4%), liver (21.6%), heart (10.0%), and lung (4.0%). The majority of recipients (60.9%) were male, and the median age at transplant was 47 years. Transplant recipients were linked to 10,656 malignancy diagnoses during follow-up, with analysis indicating an overall doubling of cancer risk compared with the general population.

Risk was increased for 32 different malignancies, some of which were related to known infections (eg, anal cancer, Kaposi sarcoma) and some were unrelated to known infections (eg, melanoma and thyroid and lip cancers). Non-Hodgkin lymphoma and cancers of the lung, liver, and kidney were the most common malignancies with elevated risk, comprising 43% of all cancer cases among the transplant recipients compared with 21% in the general US population.

Lung cancer risk was most elevated among lung recipients, but also increased among kidney, liver, and heart recipients. However, only the liver recipients had elevated risk of liver cancer. Kidney cancer risk was highest among kidney recipients, but also elevated in liver and heart recipients.

The researchers hope that these findings spur research into carcinogenic mechanisms associated with organ transplantation as well as further development of approaches to prevention and early detection of cancer in this patient population (JAMA. 2011;306[17]:1891-1901).

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