Cargando…

Cancer risk following organ transplantation: a nationwide cohort study in Sweden

A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to...

Descripción completa

Detalles Bibliográficos
Autores principales: Adami, J, Gäbel, H, Lindelöf, B, Ekström, K, Rydh, B, Glimelius, B, Ekbom, A, Adami, H-O, Granath, F
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394311/
https://www.ncbi.nlm.nih.gov/pubmed/14520450
http://dx.doi.org/10.1038/sj.bjc.6601219
_version_ 1782155386042712064
author Adami, J
Gäbel, H
Lindelöf, B
Ekström, K
Rydh, B
Glimelius, B
Ekbom, A
Adami, H-O
Granath, F
author_facet Adami, J
Gäbel, H
Lindelöf, B
Ekström, K
Rydh, B
Glimelius, B
Ekbom, A
Adami, H-O
Granath, F
author_sort Adami, J
collection PubMed
description A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to assess the risk of cancer following organ transplantation. A nationwide cohort study comprising 5931 patients who underwent transplantation of kidney, liver or other organs during 1970–1997 in Sweden was conducted. Complete follow-up was accomplished through linkage to nationwide databases. We used comparisons with the entire Swedish population to calculate standardised incidence ratios (SIRs), and Poisson regression for multivariate internal analyses of relative risks (RRs) with 95% confidence intervals (CI). Overall, we observed 692 incident first cancers vs 171 expected (SIR 4.0; 95% CI 3.7–4.4). We confirmed marked excesses of nonmelanoma skin cancer (SIR 56.2; 95% CI 49.8–63.2), lip cancer (SIR 53.3; 95% CI 38.0–72.5) and of non-Hodgkin's lymphoma (NHL) (SIR 6.0; 95% CI 4.4–8.0). Compared with patients who underwent kidney transplantation, those who received other organs were at substantially higher risk of NHL (RR 8.4; 95% CI 4.3–16). Besides, we found, significantly, about 20-fold excess risk of cancer of the vulva and vagina, 10-fold of anal cancer, and five-fold of oral cavity and kidney cancer, as well as two- to four-fold excesses of cancer in the oesophagus, stomach, large bowel, urinary bladder, lung and thyroid gland. In conclusion, organ transplantation entails a persistent, about four-fold increased overall cancer risk. The complex pattern of excess risk at many sites challenges current understanding of oncogenic infections that might become activated by immunologic alterations.
format Text
id pubmed-2394311
institution National Center for Biotechnology Information
language English
publishDate 2003
publisher Nature Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-23943112009-09-10 Cancer risk following organ transplantation: a nationwide cohort study in Sweden Adami, J Gäbel, H Lindelöf, B Ekström, K Rydh, B Glimelius, B Ekbom, A Adami, H-O Granath, F Br J Cancer Epidemiology A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to assess the risk of cancer following organ transplantation. A nationwide cohort study comprising 5931 patients who underwent transplantation of kidney, liver or other organs during 1970–1997 in Sweden was conducted. Complete follow-up was accomplished through linkage to nationwide databases. We used comparisons with the entire Swedish population to calculate standardised incidence ratios (SIRs), and Poisson regression for multivariate internal analyses of relative risks (RRs) with 95% confidence intervals (CI). Overall, we observed 692 incident first cancers vs 171 expected (SIR 4.0; 95% CI 3.7–4.4). We confirmed marked excesses of nonmelanoma skin cancer (SIR 56.2; 95% CI 49.8–63.2), lip cancer (SIR 53.3; 95% CI 38.0–72.5) and of non-Hodgkin's lymphoma (NHL) (SIR 6.0; 95% CI 4.4–8.0). Compared with patients who underwent kidney transplantation, those who received other organs were at substantially higher risk of NHL (RR 8.4; 95% CI 4.3–16). Besides, we found, significantly, about 20-fold excess risk of cancer of the vulva and vagina, 10-fold of anal cancer, and five-fold of oral cavity and kidney cancer, as well as two- to four-fold excesses of cancer in the oesophagus, stomach, large bowel, urinary bladder, lung and thyroid gland. In conclusion, organ transplantation entails a persistent, about four-fold increased overall cancer risk. The complex pattern of excess risk at many sites challenges current understanding of oncogenic infections that might become activated by immunologic alterations. Nature Publishing Group 2003-10-06 2003-09-30 /pmc/articles/PMC2394311/ /pubmed/14520450 http://dx.doi.org/10.1038/sj.bjc.6601219 Text en Copyright © 2003 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Epidemiology
Adami, J
Gäbel, H
Lindelöf, B
Ekström, K
Rydh, B
Glimelius, B
Ekbom, A
Adami, H-O
Granath, F
Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title_full Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title_fullStr Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title_full_unstemmed Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title_short Cancer risk following organ transplantation: a nationwide cohort study in Sweden
title_sort cancer risk following organ transplantation: a nationwide cohort study in sweden
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394311/
https://www.ncbi.nlm.nih.gov/pubmed/14520450
http://dx.doi.org/10.1038/sj.bjc.6601219
work_keys_str_mv AT adamij cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT gabelh cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT lindelofb cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT ekstromk cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT rydhb cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT glimeliusb cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT ekboma cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT adamiho cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden
AT granathf cancerriskfollowingorgantransplantationanationwidecohortstudyinsweden