Patients who have received a solid organ transplant such as kidney, liver, heart or lung, have an overall cancer risk double that of the general population, with an increased risk for many different types of malignancies, according to a study.
Writing in the Nov. 2 issue of JAMA, the researchers noted 28,664 transplants took place nationally in 2010. Solid organ transplant recipients have an increased cancer risk because of immunosuppression and oncogenic viral infections.
Eric A. Engels, MD, MPH, of the National Cancer Institute in Rockville, Md., and colleagues conducted a study to examine the overall pattern of cancer after solid organ transplantation. Their data included 175,732 transplants (39.7% of the U.S. total during the time span studied, 1987-2008). Most of the included recipients were male (60.9%), and the median age at transplant was 47. The most common transplanted organs were kidney (58.4%), liver (21.6%), heart (10%) and lung (4%).
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 related to known infections (such as anal cancer, Kaposi sarcoma) and others unrelated to infection (such as melanoma, thyroid and lip cancers). The most common malignancies with elevated risk were non-Hodgkin lymphoma (1,504 cases) and cancers of the lung (1,344), liver (930) and kidney (752), which together made up 43% of all cancer cases in transplant recipients compared with 21% in the U.S. general population.
Non-Hodgkin lymphoma risk was elevated, compared with the general population, for recipients of all organ types. For lung cancer, the elevated risk was greatest among lung recipients but also was present for recipients of other organs (kidney, liver and heart). Liver cancer risk was elevated only for liver recipients. Kidney cancer risk was highest in kidney recipients but also was elevated among liver and heart recipients.
"Some malignancies arise from the loss of immunologic control of oncogenic viruses, but others are unrelated to known infections," the authors wrote. "Additional contributing factors for some cancers may include other effects of chronic immune disturbance or inflammation, underlying medical conditions or medication toxicity.
"Our findings should stimulate research into carcinogenic mechanisms associated with organ transplantation. The elevated risk for a broad range of malignancies among transplant recipients, coupled with improvements in long-term survival, should encourage further development of approaches to prevention and early detection of cancer targeted to this population."
To read a study summary and access the study via subscription or purchase, visit http://bit.ly/tI0lUS.
Writing in the Nov. 2 issue of JAMA, the researchers noted 28,664 transplants took place nationally in 2010. Solid organ transplant recipients have an increased cancer risk because of immunosuppression and oncogenic viral infections.
Eric A. Engels, MD, MPH, of the National Cancer Institute in Rockville, Md., and colleagues conducted a study to examine the overall pattern of cancer after solid organ transplantation. Their data included 175,732 transplants (39.7% of the U.S. total during the time span studied, 1987-2008). Most of the included recipients were male (60.9%), and the median age at transplant was 47. The most common transplanted organs were kidney (58.4%), liver (21.6%), heart (10%) and lung (4%).
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 related to known infections (such as anal cancer, Kaposi sarcoma) and others unrelated to infection (such as melanoma, thyroid and lip cancers). The most common malignancies with elevated risk were non-Hodgkin lymphoma (1,504 cases) and cancers of the lung (1,344), liver (930) and kidney (752), which together made up 43% of all cancer cases in transplant recipients compared with 21% in the U.S. general population.
Non-Hodgkin lymphoma risk was elevated, compared with the general population, for recipients of all organ types. For lung cancer, the elevated risk was greatest among lung recipients but also was present for recipients of other organs (kidney, liver and heart). Liver cancer risk was elevated only for liver recipients. Kidney cancer risk was highest in kidney recipients but also was elevated among liver and heart recipients.
"Some malignancies arise from the loss of immunologic control of oncogenic viruses, but others are unrelated to known infections," the authors wrote. "Additional contributing factors for some cancers may include other effects of chronic immune disturbance or inflammation, underlying medical conditions or medication toxicity.
"Our findings should stimulate research into carcinogenic mechanisms associated with organ transplantation. The elevated risk for a broad range of malignancies among transplant recipients, coupled with improvements in long-term survival, should encourage further development of approaches to prevention and early detection of cancer targeted to this population."
To read a study summary and access the study via subscription or purchase, visit http://bit.ly/tI0lUS.
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