Increased Risk of Cancer After Kidney Transplantation
Immune suppression may explain the increased risk
TUESDAY, Dec. 19 (HealthDay News) -- Kidney transplant patients are at higher risk of cancer at a variety of sites, suggesting that the link between the etiology of cancer and the immune system is stronger than previously thought, according to a study in the Dec. 20 issue of the Journal of the American Medical Association.
Claire M. Vajdic, Ph.D., of the University of New South Wales in Sydney, Australia, and colleagues analyzed data on 28,855 patients with end-stage kidney disease who had received renal replacement therapy and who were followed up for 273,407 person-years.
Cancers associated with end-stage kidney disease and non-melanoma skin cancer were excluded from the analysis, and after these exclusions, there were 1,236 cases of cancer, a 3.27 percent standardized incidence ratio (SIR). During dialysis, the SIR was only 1.35, with 870 reported cases. At 18 cancer sites, the SIR increased more than threefold after transplantation, usually due to a cancer with etiology thought or known to be viral.
"The magnitude and breadth of the increased risk after transplantation suggests that immune suppression causes a substantial and broad-ranging increase in cancer risk," the authors write. "Our findings point to an important role of the interaction between common viral infections and the immune system in the etiology of cancers at a broad range of sites."