New Data on Cancer Risk after Organ Transplantation

Patients with kidney or other solid organ transplants are at increased risk of a wide range of cancers, reports a study in The Journal of the American Medical Association.

The researchers used linked cancer registries to analyze patterns of cancer risk after organ transplantation. The analysis included data on 175,732 solid organ transplant recipients, approximately 58 percent of whom received kidney transplants. The rest received liver (22 percent), heart (10 percent), and lung (4 percent) transplants.

The overall incidence of cancer after organ transplant was 1375 per 100,000 person-years, with a standardized incidence ratio (SIR) of 2.0. The increase was seen not only for infection-related cancers such as Kaposi sarcoma and anal cancer; but also for cancers with no known link to infection, such as melanoma, thyroid cancer, and lip cancer. The most common cancers showing excess risk were non-Hodgkin lymphoma, SIR 7.54; lung cancer, SIR 1.97; liver cancer, SIR 11.56; and kidney cancer, SIR 4.65.

Lung cancer risk was highest in lung transplant recipients, but was also increased for kidney recipients: SIR 1.46. The risk of kidney cancer was highest for kidney transplant recipients, SIR 6.66, with an initial peak in the first year and a second peak during years 4 to 15. Kidney cancer risk was also increased for liver and heart recipients: SIR 1.80 and 2.90, respectively.

The results show an increased risk of a wide range of cancers—including cancers apparently unrelated to infection—in kidney, liver, heart, and lung recipients. Especially with improvement in long-term survival rates, new approaches to cancer prevention and early detection after organ transplantation are needed [Engels EA, et al: Spectrum of cancer risk among US solid organ transplant recipients. JAMA 2011; 306:1891–1901].