Cancer-attributable mortality among solid organ transplant recipients in the United States: 1987 through 2014

Anne-Michelle Noone; Ruth M Pfeiffer; Joanne F Dorgan; Laurence S Magder; Jonathan S Bromberg; Charles F Lynch; Cyllene R Morris; Karen S Pawlish; Eric A Engels

doi:10.1002/cncr.32136

Back

Cancer-attributable mortality among solid organ transplant recipients in the United States: 1987 through 2014

Journal article

Open access

Peer reviewed

Cancer-attributable mortality among solid organ transplant recipients in the United States: 1987 through 2014

Anne-Michelle Noone, Ruth M Pfeiffer, Joanne F Dorgan, Laurence S Magder, Jonathan S Bromberg, Charles F Lynch, Cyllene R Morris, Karen S Pawlish and Eric A Engels

Cancer, Vol.125(15), pp.2647-2655

08/01/2019

DOI: 10.1002/cncr.32136

PMCID: PMC6625902

PMID: 31034602

Files and links (1)

url

https://doi.org/10.1002/cncr.32136View

Published (Version of record) Open Access

Abstract

Solid organ transplant recipients have an elevated risk of cancer. Quantifying deaths attributable to cancer can inform priorities to reduce cancer burden. Linked transplantation and cancer registry data were used to identify incident cancers and deaths among solid organ transplant recipients in the United States (1987-2014). Population-attributable fractions (PAFs) of deaths due to cancer and corresponding cancer-attributable mortality rates were estimated using Cox models. Among 221,962 solid organ transplant recipients, 15,012 developed cancer. Approximately 13% of deaths (PAF, 13.2%) were attributable to cancer, corresponding to a cancer-attributable mortality rate of 516 per 100,000 person-years. Lung cancer was the largest contributor to mortality (PAF, 3.1%), followed by non-Hodgkin lymphoma (NHL; PAF, 1.9%), colorectal cancer (PAF, 0.7%), and kidney cancer (PAF, 0.5%). Cancer-attributable mortality rates increased with age at transplantation, reaching 1229 per 100,000 person-years among recipients aged ≥65 years. NHL was the largest contributor among children (PAF, 4.1%) and lung cancer was the largest contributor among recipients aged ≥50 years (PAFs, 3.7%-4.3%). Heart recipients had the highest PAF (16.4%), but lung recipients had the highest cancer-attributable mortality rate (1241 per 100,000 person-years). Overall, mortality attributable to cancer increased steadily with longer time since transplantation, reaching 15.7% of deaths (810 per 100,000 person-years) at ≥10 years after transplantation. Comparison of cancer-attributable mortality rates with specified causes of death indicated that some deaths recorded as other causes might instead be caused by cancer or its treatment. Cancer is a substantial cause of mortality among solid organ transplant recipients, with major contributions reported from lung cancer and NHL. Cancer-attributable mortality increases with age and time since transplantation, and therefore cancer deaths will become an increasing burden as recipients live longer.

History, 21st Century

United States

History, 20th Century

Humans

Middle Aged

Risk Factors

Child, Preschool

Neoplasms - mortality

Infant

Male

Young Adult

Organ Transplantation - adverse effects

Adolescent

Adult

Female

Organ Transplantation - methods

Aged

Child

Infant, Newborn

Transplant Recipients - statistics & numerical data

Details

Title: Subtitle: Cancer-attributable mortality among solid organ transplant recipients in the United States: 1987 through 2014
Creators: Anne-Michelle Noone - Divison of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
Ruth M Pfeiffer - Divison of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
Joanne F Dorgan - Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Laurence S Magder - Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Jonathan S Bromberg - Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
Charles F Lynch - Department of Epidemiology, University of Iowa, Iowa City, Iowa
Cyllene R Morris - Institute for Population Health Improvement, UC Davis Health System, Sacramento, California
Karen S Pawlish - Cancer Epidemiology Services, New Jersey Department of Health, Trenton, New Jersey
Eric A Engels - Divison of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
Resource Type: Journal article
Publication Details: Cancer, Vol.125(15), pp.2647-2655
DOI: 10.1002/cncr.32136
PMID: 31034602
PMCID: PMC6625902
NLM abbreviation: Cancer
ISSN: 1097-0142
eISSN: 1097-0142
Publisher: United States
Grant note: N01PC35142 / NCI NIH HHS U58 DP000807 / NCCDPHP CDC HHS U58 DP000824 / NCCDPHP CDC HHS U58 DP003920 / NCCDPHP CDC HHS U58 DP000848 / NCCDPHP CDC HHS HHSN261201000036C / NCI NIH HHS HHSN261201000034C / NCI NIH HHS U58 DP003875 / NCCDPHP CDC HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS HHSN261201300021C / NCI NIH HHS N01PC35137 / NCI NIH HHS U58 DP003921 / NCCDPHP CDC HHS HHSN261201300011I / NCI NIH HHS HHSN261201000037C / NCI NIH HHS HHSN261201000035C / NCI NIH HHS N01PC35143 / NCI NIH HHS Z99 CA999999 / Intramural NIH HHS HHSN261201300011C / CCR NIH HHS HHSN261201300071C / NCI NIH HHS U58 DP003933 / NCCDPHP CDC HHS U58 DP003883 / NCCDPHP CDC HHS P30 AG028747 / NIA NIH HHS HHSN261201000035I / NCI NIH HHS
Language: English
Date published: 08/01/2019
Academic Unit: Epidemiology
Record Identifier: 9983996099302771

Metrics

18 Record Views

34 Times Cited - Web of Science