Journal article
Risk of Colorectal Cancer After Solid Organ Transplantation in the United States
American journal of transplantation, Vol.16(3), pp.960-967
03/2016
DOI: 10.1111/ajt.13549
PMCID: PMC5218822
PMID: 26731613
Abstract
Solid organ transplant recipients have increased colorectal cancer (CRC) risk. We assessed CRC risk among transplant recipients and identified factors contributing to this association. The US transplant registry was linked to 15 population-based cancer registries (1987-2010). We compared CRC risk in recipients to the general population by using standardized incidence ratios (SIRs) and identified CRC risk factors by using Poisson regression. Based on 790 cases of CRC among 224 098 transplant recipients, the recipients had elevated CRC risk (SIR 1.12, 95% confidence interval [CI] 1.04 to 1.20). The increase was driven by an excess of proximal colon cancer (SIR 1.69, 95% CI 1.53 to 1.87), while distal colon cancer was not increased (SIR 0.93, 95% CI 0.80 to 1.07), and rectal cancer was reduced (SIR 0.64, 95% CI 0.54 to 0.76). In multivariate analyses, CRC was increased markedly in lung recipients with cystic fibrosis (incidence rate ratio [IRR] 12.3, 95% CI 6.94 to 21.9, vs. kidney recipients). Liver recipients with primary sclerosing cholangitis and inflammatory bowel disease also had elevated CRC risk (IRR 5.32, 95% CI 3.73 to 7.58). Maintenance therapy with cyclosporine and azathioprine was associated with proximal colon cancer (IRR 1.53, 95% CI 1.05 to 2.23). Incidence was not elevated in a subgroup of kidney recipients treated with tacrolimus and mycophenolate mofetil, pointing to the relevance of the identified risk factors. Transplant recipients have increased proximal colon cancer risk, likely related to underlying medical conditions (cystic fibrosis and primary sclerosing cholangitis) and specific immunosuppressive regimens.
Details
- Title: Subtitle
- Risk of Colorectal Cancer After Solid Organ Transplantation in the United States
- Creators
- M Safaeian - Division of Cancer Epidemiology and Genetics, National Cancer Institute/National Institutes of Health/Department of Health and Human Services, Bethesda, MDH A Robbins - Division of Cancer Epidemiology and Genetics, National Cancer Institute/National Institutes of Health/Department of Health and Human Services, Bethesda, MDS I Berndt - Division of Cancer Epidemiology and Genetics, National Cancer Institute/National Institutes of Health/Department of Health and Human Services, Bethesda, MDC F Lynch - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IAJ F Fraumeni Jr - Division of Cancer Epidemiology and Genetics, National Cancer Institute/National Institutes of Health/Department of Health and Human Services, Bethesda, MDE A Engels - Division of Cancer Epidemiology and Genetics, National Cancer Institute/National Institutes of Health/Department of Health and Human Services, Bethesda, MD
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.16(3), pp.960-967
- DOI
- 10.1111/ajt.13549
- PMID
- 26731613
- PMCID
- PMC5218822
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6143
- eISSN
- 1600-6143
- Publisher
- United States
- Grant note
- Z99 CA999999 / Intramural NIH HHS T32 CA009314 / NCI NIH HHS P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 03/2016
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995038802771
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