Clinical InvestigationChanges in cancer incidence and outcomes among kidney transplant recipients in the United States over a thirty-year period
Graphical abstract
Section snippets
Results
We evaluated a cohort of 101,014 KTRs, with 351,127 person-years of follow-up over 3 decades of transplantation (1987–2016). Most KTRs were male (60.2%). Recipients in this study were similar to the changing US KTR population (Table 1). In particular, there was an increase in age at transplantation over time (mean age 44.3, 48.6, and 50.9 years for transplants in 1987–1996, 1997–2006, and 2007–2016, respectively) and growing racial/ethnic diversity. We also observed increasing body mass index
Discussion
Cancer continues to be a major cause of morbidity and mortality in KTRs. In the present study, there was no overall change in cancer incidence across a 30-year period in the United States. KTRs with NHL had improved outcomes over time, with declines in the relative risk of DWFG and DCGF, but there was no change in these associations for other cancers combined. Indeed, the absolute risks of DWFG and graft failure after cancer diagnosis remained high for the most recent KTRs who were transplanted
Methods
The Transplant Cancer Match Study (https://www.transplantmatch.cancer.gov) is a cohort study linking data on US solid organ transplant recipients from the Scientific Registry of Transplant Recipients (SRTR) with population-based cancer registries.3 At the time of this study, the Transplant Cancer Match Study included data for 1987 to 2016 from 18 state and metropolitan area cancer registries (see Table 1 footnote) covering approximately half of the US transplant population based on the state of
Disclosure
CDB has received honoraria from CareDx and Natera. All the other authors declared no competing interests.
Acknowledgments
This research was supported in part by the Intramural Research Program of the National Cancer Institute. We gratefully acknowledge the support and assistance provided by individuals at the Health Resources and Services Administration (Monica Lin), the Scientific Registry of Transplant Recipients (SRTR) (Ajay Israni, Bertram Kasiske, Paul Newkirk, and Jon Snyder), and the following cancer registries: the states of California (Tina Clarke), Colorado (Jack Finch), Connecticut (Lou Gonsalves),
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