Journal article
Cancer Mortality Among Solid Organ Transplant Recipients in the United States During 1987-2018
Transplantation, Vol.107(11), pp.2433-2442
11/2023
DOI: 10.1097/TP.0000000000004694
PMCID: PMC10615843
PMID: 37291711
Abstract
Background.
Solid organ transplant recipients (ie, “recipients”) have elevated cancer risk and reduced survival after a cancer diagnosis. Evaluation of cancer mortality among recipients can facilitate improved outcomes from cancers arising before and after transplantation.
Methods.
We linked the US transplant registry to the National Death Index to ascertain the causes of 126 474 deaths among 671 127 recipients (1987–2018). We used Poisson regression to identify risk factors for cancer mortality and calculated standardized mortality ratios to compare cancer mortality in recipients with that in the general population. Cancer deaths verified with a corresponding cancer diagnosis from a cancer registry were classified as death from pretransplant or posttransplant cancers.
Results.
Thirteen percent of deaths were caused by cancer. Deaths from lung cancer, liver cancer, and non-Hodgkin lymphoma (NHL) were the most common. Heart and lung recipients had the highest mortality for lung cancer and NHL, whereas liver cancer mortality was highest among liver recipients. Compared with the general population, cancer mortality was elevated overall (standardized mortality ratio 2.33; 95% confidence interval, 2.29-2.37) and for most cancer sites, with large increases from nonmelanoma skin cancer (23.4, 21.5-25.5), NHL (5.17, 4.87-5.50), kidney cancer (3.40, 3.10-3.72), melanoma (3.27, 2.91-3.68), and, among liver recipients, liver cancer (26.0, 25.0-27.1). Most cancer deaths (93.3%) were associated with posttransplant cancer diagnoses, excluding liver cancer deaths in liver recipients (of which all deaths were from pretransplant diagnoses).
Conclusions.
Improved posttransplant prevention or screening for lung cancer, NHL, and skin cancers and management of liver recipients with prior liver cancer may reduce cancer mortality among recipients.
Details
- Title: Subtitle
- Cancer Mortality Among Solid Organ Transplant Recipients in the United States During 1987-2018
- Creators
- Jeanny H Wang - National Cancer InstituteRuth M Pfeiffer - National Cancer InstituteDonnie Musgrove - Hennepin Healthcare Research InstituteDavid Castenson - Information Management ServicesMark Fredrickson - Hennepin Healthcare Research InstituteJon Miller - Hennepin Healthcare Research InstituteLou Gonsalves - Connecticut Department of Public HealthMei-Chin Hsieh - Louisiana State University Health Sciences Center New OrleansCharles F Lynch - University of IowaYun Zeng - University of North DakotaKelly J Yu - National Cancer InstituteAllyson Hart - Hennepin Healthcare Research InstituteAjay K Israni - Hennepin Healthcare Research InstituteJon J Snyder - Hennepin Healthcare Research InstituteEric A Engels - National Cancer Institute
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.107(11), pp.2433-2442
- DOI
- 10.1097/TP.0000000000004694
- PMID
- 37291711
- PMCID
- PMC10615843
- NLM abbreviation
- Transplantation
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Language
- English
- Electronic publication date
- 06/09/2023
- Date published
- 11/2023
- Academic Unit
- Epidemiology
- Record Identifier
- 9984430331902771
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