Cancer risk in living kidney donors

Eric A Engels; Gary E Fraser; Bertram L Kasiske; Jon J Snyder; Jason Utt; Charles F Lynch; Jie Li; Karen S Pawlish; Sandra Brown; Kelly J Yu; Ruth M Pfeiffer

doi:10.1111/ajt.17082

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Cancer risk in living kidney donors

Eric A Engels, Gary E Fraser, Bertram L Kasiske, Jon J Snyder, Jason Utt, Charles F Lynch, Jie Li, Karen S Pawlish, Sandra Brown, Kelly J Yu, …

American journal of transplantation, Vol.22(8), pp.2006-2015

05/05/2022

DOI: 10.1111/ajt.17082

PMCID: PMC9357116

PMID: 35510728

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Abstract

Living kidney donors are screened for transmissible diseases including cancer. Outcomes following donation are excellent, but concern exists regarding development of chronic kidney disease, and cancer risk is unknown. We used linked transplant and cancer registry data to identify incident cancers among 84,357 kidney donors in the United States (1995-2017). We compared risk to the general population using standardized incidence ratios (SIRs). For selected cancers, we used Poisson regression to compare donors to 47,451 Adventist Health Study 2 (AHS-2) participants, who typically have healthy lifestyles. During follow-up, 2843 cancers were diagnosed in donors, representing an overall deficit (SIR 0.79, 95%CI 0.76-0.82). None of 46 specified cancer sites occurred in excess relative to the general population, and 15 showed significant deficits (SIR<1.00). Compared with AHS-2 participants, donors had similar incidence of liver cancer, melanoma, breast cancer, and non-Hodgkin lymphoma but, starting seven years after donation, elevated incidence of colorectal cancer (adjusted incidence rate ratio 2.07, 95%CI 154-2.79) and kidney cancer starting (2.97, 1.58-5.58, accounting for the presence of a single kidney in donors). Elevated kidney cancer incidence may reflect adverse processes in donors' remaining kidney. Nonetheless, cancer risk is lower than in the general population, suggesting that enhanced screening is unnecessary.

Details

Title: Subtitle: Cancer risk in living kidney donors
Creators: Eric A Engels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
Gary E Fraser
Bertram L Kasiske - Scientific Registry of Transplant Recipients, Minneapolis, MN, USA
Jon J Snyder - Scientific Registry of Transplant Recipients, Minneapolis, MN, USA
Jason Utt - Loma Linda University
Charles F Lynch - University of Iowa
Jie Li - New Jersey Department of Health
Karen S Pawlish - New Jersey Department of Health
Sandra Brown - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
Kelly J Yu - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
Ruth M Pfeiffer - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
Resource Type: Journal article
Publication Details: American journal of transplantation, Vol.22(8), pp.2006-2015
DOI: 10.1111/ajt.17082
PMID: 35510728
PMCID: PMC9357116
NLM abbreviation: Am J Transplant
eISSN: 1600-6143
Language: English
Date published: 05/05/2022
Academic Unit: Epidemiology
Record Identifier: 9984256160102771

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