Liver transplantation and subsequent risk of cancer: Findings from a Canadian cohort study

Citations Over TimeTop 10% of 2008 papers

Abstract

Characterization of the long-term cancer risks among liver transplant patients has been hampered by the paucity of sufficiently large cohorts. The increase over time in the number of liver transplants coupled with improved survival underscores the need to better understand associated long-term health effects. This is a cohort study whose subjects were assembled with data from the population-based Canadian Organ Replacement Registry. Analyses are based on 2034 patients who received a liver transplant between June 1983 and October 1998. Incident cases of cancer were identified through record linkage to the Canadian Cancer Registry. We compared site-specific cancer incidence rates in the cohort and the general Canadian population by using the standardized incidence ratio (SIR). Stratified analyses were performed to examine variations in risk according to age at transplantation, sex, time since transplantation, and year of transplantation. Liver transplant recipients had cancer incidence rates that were 2.5 times higher than those of the general population [95% confidence interval (CI) = 2.1, 3.0]. The highest SIR was observed for non-Hodgkin's lymphoma (SIR = 20.8, 95% CI = 14.9, 28.3), whereas a statistically significant excess was observed for colorectal cancer (SIR = 2.6, 95% CI = 1.4, 4.4). Risks were more pronounced during the first year of follow-up and among younger transplant patients. In conclusion, our findings indicate that liver transplant patients face increased risks of developing cancer with respect to the general population. Increased surveillance in this patient population, particularly in the first year following transplantation, and screening for colorectal cancer with modalities for which benefits are already well recognized should be pursued.

Related Papers

• → Population-based incidence estimates of uveal melanoma in Germany. Supplementing cancer registry data by case–control data(2006)16 cited
• → Liver transplantation and BCLC classification: Limitations impede optimum treatment(2020)9 cited
• Completeness of Reporting for Breast Cancer Data in the National Pathology-Based Cancer Registry in South Africa.(2021)
• Evaluation of the effect of Papanicolaou screening in Sweden: record linkage between a central screening registry and the National Cancer Registry.(1986)
• → Probabilistic Record Linkage of Anonymous Cancer Registry Records(2005)