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> (2000-2004)
> Granath F
> Uppsala University >
Cancer risk followi...
Cancer risk following organ transplantation : a nationwide cohort study in Sweden
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Adami, Johanna (author)
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Gäbel, H. (author)
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- Lindelöf, B. (author)
- Karolinska Institutet
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- Ekström, K. (author)
- Karolinska Institutet
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Rydh, B. (author)
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- Glimelius, Bengt (author)
- Karolinska Institutet,Uppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,Onko
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- Ekbom, A. (author)
- Karolinska Institutet
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- Adami, Hans-Olov (author)
- Karolinska Institutet
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- Granath, F. (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2003-09-30
- 2003
- English.
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In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 89:7, s. 1221-1227
- Related links:
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https://www.nature.c...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Subject headings
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- A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to assess the risk of cancer following organ transplantation. A nationwide cohort study comprising 5931 patients who underwent transplantation of kidney, liver or other organs during 1970-1997 in Sweden was conducted. Complete follow-up was accomplished through linkage to nationwide databases. We used comparisons with the entire Swedish population to calculate standardised incidence ratios (SIRs), and Poisson regression for multivariate internal analyses of relative risks (RRs) with 95% confidence intervals (CI). Overall, we observed 692 incident first cancers vs 171 expected (SIR 4.0; 95% CI 3.7-4.4). We confirmed marked excesses of nonmelanoma skin cancer (SIR 56.2; 95% CI 49.8-63.2), lip cancer (SIR 53.3; 95% CI 38.0-72.5) and of non-Hodgkin's lymphoma (NHL) (SIR 6.0; 95% CI 4.4-8.0). Compared with patients who underwent kidney transplantation, those who received other organs were at substantially higher risk of NHL (RR 8.4; 95% CI 4.3-16). Besides, we found, significantly, about 20-fold excess risk of cancer of the vulva and vagina, 10-fold of anal cancer, and five-fold of oral cavity and kidney cancer, as well as two- to four-fold excesses of cancer in the oesophagus, stomach, large bowel, urinary bladder, lung and thyroid gland. In conclusion, organ transplantation entails a persistent, about four-fold increased overall cancer risk. The complex pattern of excess risk at many sites challenges current understanding of oncogenic infections that might become activated by immunologic alterations.
Keyword
- organ transplantation
- epidemiology
- cohort study
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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