Relative and absolute cancer risks among Nordic kidney transplant recipients-a population-based study.

2020 
Background Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. Methods All KTRs in Sweden, Norway, Denmark and Finland, with a first transplantation between 1995-2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER) and cumulative incidence of cancer in the presence of competing risks. Results Overall, 12,984 KTRs developed 2,215 cancers. The incidence rate of cancer overall was 3-fold increased (SIR 3.3, 95% confidence interval [CI]: 3.2-3.4). The AER of any cancer was 1,560 cases (95% CI: 1,468-1,656) per 100,000 person-years. The highest AERs were observed for non-melanoma skin cancer (838, 95% CI: 778-901), non-Hodgkin lymphoma (145, 95% CI: 119-174), lung cancer (126, 95% CI: 98.2-149) and kidney cancer (122, 95% CI: 98.0-149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6-8.6%) and 16.8% (95% CI: 16.0-17.6%), respectively. Conclusion Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.
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