Cancer risk after renal transplantation in Japan

Abstract

Excess of cancer in patients receiving renal transplantation is well-known in Western countries, but information in Japan remains limited. Our study examined whether excess risk is found in patients receiving renal transplantation in Japan. Between 1970 and 1995, 1155 males and 589 females underwent renal transplantation in 6 hospitals, and a total of 12,982 person-years of observation was accumulated. Malignancies developed in 2.6% of patients; O/E ratio was 2.78. Median interval from renal transplantation to tumor development was 58 months. The interval in the patients receiving medication with cyclosporine-A (CyA) (median, 42.5 months) was significantly shorter than that with non-CyA (median, 95.5 months). Median age at the diagnosis of malignancy was 40 years, which is much younger than that in the general population. Relative risk was highest in renal cancer, followed by thyroid cancer, malignant lymphoma and uterine cancer. A distribution of malignancies was different from that reported from Western countries. These findings showed the excess risk of malignancies in Japan with renal transplants, especially in male patients, similar to that observed in Western countries, though the types of malignancy were different.

Cancer risk following organ transplantation: a nationwide cohort study in Sweden

“…Moreover, we confirmed a significantly higher overall risk among patients transplanted at young age, among men compared with women, and following transplantation of organs other than a kidney (Kinlen, 1992;Penn, 2000). For specific cancer sites, the excess risk was most notable for nonmelanoma skin cancer, lip cancer and NHL, which is in accordance with other investigators (Hoover and Fraumeni, 1973;Kinlen et al, 1979;Blohme and Brynger, 1985;Barr et al, 1989;Kinlen, 1992;Opelz and Heneerson, 1993;Birkeland et al, 1995Birkeland et al, , 2000Bouwes Bavinck et al, 1997;Hoshida et al, 1997;Kyllonen et al, 2000;Lindelof et al, 2000;Penn, 2000). In the study by Lindelöf et al (2000), the SIRs included all incident cancers, whereas in our study, we only counted the first cancer.…”

“…Although cancer risk following organ transplantation has been analysed in several prospective studies, only few of them were population based with long-term follow-up (Hoover and Fraumeni, 1973;Kinlen et al, 1979;Birkeland et al, 1995Birkeland et al, , 2000Hoshida et al, 1997;Kyllonen et al, 2000;Lindelof et al, 2000), and except for one of the studies (Lindelof et al, 2000), none of them included patients with another transplanted organ than a kidney. While components of our study have been included in earlier analyses (Birkeland et al, 1995) and chiefly in a publication focused on skin cancer (Lindelof et al, 2000), the cohort has now been expanded and the follow-up time added.…”

Risk of Kaposi's sarcoma and of other cancers in Italian renal transplant patients

“…The overall increase in cancer risk we found (1.8-fold) is somewhat lower than that reported from previous investigations in transplant patients (Kinlen et al, 1979;Birkeland et al, 1995;Hoshida et al, 1997;Adami et al, 2003), but the exclusion in our analysis of nonmelanoma skin cancers explains a large part of this difference.…”

“…Kaposi's sarcoma (KS) has been frequently reported in transplant patients in the United States (Penn, 2000), in the Middle East (Qunibi et al, 1988) and in Italy (Montagnino et al, 1996;Pedotti et al, 2003), but the excess risk has not been closely quantified. No increased risk of KS has been reported in transplant patients from the Nordic countries (Birkeland et al, 1995(Birkeland et al, , 2000Adami et al, 2003), or Japan (Hoshida et al, 1997).…”

“…The overall cancer risk is three-to four-fold elevated, but some specific cancers show greater increases (Kinlen, 1992). For nonmelanoma skin cancers and lip cancer, the relative risks are increased 10-to 60-fold (Kinlen et al, 1979;Birkeland et al, 1995;Adami et al, 2003), while the excess of non-Hodgkin's lymphoma (NHL) is about five-to 10-fold (Hoshida et al, 1997;Birkeland et al, 2000;Adami et al, 2003). Kaposi's sarcoma (KS) has been frequently reported in transplant patients in the United States (Penn, 2000), in the Middle East (Qunibi et al, 1988) and in Italy (Montagnino et al, 1996;Pedotti et al, 2003), but the excess risk has not been closely quantified.…”