Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Henrik Benoni
  • Sandra Eloranta
  • Dag O. Dahle
  • My H.S. Svensson
  • Arno Nordin
  • Jan Carstens
  • Geir Mjøen
  • Ilkka Helanterä
  • Vivan Hellström
  • Gunilla Enblad
  • Eero Pukkala
  • Sørensen, Søren Schwartz
  • Marko Lempinen
  • Karin E. Smedby

Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2–3.4). The AER of any cancer was 1560 cases (95% CI: 1468–1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778–901), non-Hodgkin lymphoma (145, 95% CI: 119–174), lung cancer (126, 95% CI: 98.2–149), and kidney cancer (122, 95% CI: 98.0–149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6–8.6%) and 16.8% (95% CI: 16.0–17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.

OriginalsprogEngelsk
TidsskriftTransplant International
Vol/bind33
Udgave nummer12
Sider (fra-til)1700-1710
Antal sider11
ISSN0934-0874
DOI
StatusUdgivet - 2020

Bibliografisk note

Funding Information:
This study was supported by the Strategic research program in epidemiology at Karolinska Institutet, and by ScandiaTransplant. Novartis provided funding for meetings and travel during the planning phase of the study. We thank ScandiaTransplant and the Renal Registries of respective country for access to data. The study has also used data from the Cancer Registries of Norway, Sweden, Denmark, and Finland. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway, Sweden, Denmark, or Finland is intended nor should be inferred.

Funding Information:
Sandra Eloranta is funded via a public–private real world evidence collaboration between Karolinska institutet and Janssen pharmaceuticals (contract: 5‐63/2015).

Publisher Copyright:
© 2020 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT

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