Journal article
Risk of lung cancer in lung transplant recipients in the United States
American journal of transplantation, Vol.19(5), pp.1478-1490
05/2019
DOI: 10.1111/ajt.15181
PMCID: PMC6872188
PMID: 30565414
Abstract
Lung transplant recipients have an increased risk of lung cancer that is poorly understood. Prior studies are largely descriptive and single‐center, and have not examined risk factors or outcomes in this population. This registry‐linkage study utilized matched transplant and cancer registry data from 17 US states/regions during 1987‐2012. We used standardized incidence ratios (SIRs) to compare incidence with the general population, Poisson models to identify lung cancer risk factors, and Cox models to compare survival after diagnosis. Lung cancer risk was increased among lung recipients (SIR 4.8, 95% confidence interval [CI] 4.1‐5.5). Those with single lung transplant had 13‐fold (95% CI 11‐15) increased risk in the native lung. Native lung cancer risk factors included age, prior smoking, time since transplant, and idiopathic pulmonary fibrosis. Compared with cases in the general population, lung cancers in recipients were more frequently localized stage (P = .02) and treated surgically (P = .05). However, recipients had higher all‐cause (adjusted hazard ratio 1.90, 95% CI 1.52‐2.37) and cancer‐specific mortality (adjusted hazard ratio 1.67, 95% CI 1.28‐2.18). In conclusion, lung cancer risk is increased after lung transplant, especially in the native lung of single lung recipients. Traditional risk factors are associated with lung cancer in these patients. Lung cancer survival is worse among lung recipients despite earlier diagnosis.
In this registry‐linkage study using matched transplant and cancer registry data, the authors compare lung cancer risk, risk factors, stage, and survival between lung transplant recipients and the general population, demonstrating an elevated risk of lung cancer and poor survival among transplant recipients.
Details
- Title: Subtitle
- Risk of lung cancer in lung transplant recipients in the United States
- Creators
- Matthew Triplette - Fred Hutchinson Cancer Research CenterKristina Crothers - University of WashingtonParag Mahale - National Cancer InstituteElizabeth L Yanik - Washington University in St. LouisMaryam Valapour - Minneapolis Medical Research FoundationCharles F Lynch - University of IowaMatthew B Schabath - H. Lee Moffitt Cancer Center & Research InstituteDavid Castenson - Information Management ServicesEric A Engels - National Cancer Institute
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.19(5), pp.1478-1490
- DOI
- 10.1111/ajt.15181
- PMID
- 30565414
- PMCID
- PMC6872188
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Number of pages
- 13
- Grant note
- National Heart, Lung, and Blood Institute (T32 HL007287) Intramural Research Program of the National Cancer Institute
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995042602771
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