Organ Transplant Recipients Have Increased Cancer Risk
People who have received a solid organ transplant (such as a kidney or liver) are twice as likely as people in the general population to develop cancer. These results were published in the Journal of the American Medical Association.
In 2010, more than 28,000 solid organ transplants were performed in the United States. These procedures can be life-saving for people with advanced organ disease.
Cancer risk is known to be elevated among transplant recipients. Immunosuppression is thought to play an important role in this increased risk, but other factors may contribute as well.
To further explore cancer risk among transplant recipients, researchers collected information about 175,732 transplants. The median age at the time of transplant was 47. The most common types of transplanted organs were kidney (58%), liver (22%), heart (10%), and lung (4%).
- During follow-up, more than 10,000 cases of cancer occurred among transplant recipients. This is roughly twice what would be expected in the general population. Risk was increased for cancers related to infection (e.g. non-Hodgkin lymphoma, Kaposi sarcoma, Hodgkin lymphoma, and cancers of the liver, stomach, oropharynx, anus, vulva and penis) as well as several other types of cancer.
- Of the cancers that were more common in transplant recipients, the four most common were non-Hodgkin lymphoma, lung cancer, liver cancer, and kidney cancer. Risk of non-Hodgkin lymphoma was increased for recipients of any type of organ. For lung cancer, risk was greatest among lung recipients, but was also increased for recipients of other types of organs. Risk of liver cancer was elevated only among liver recipients. Risk of kidney cancer was highest among kidney recipients, but was also increased for liver and heart recipients.
The study suggests that organ transplant recipients are at increased risk for a wide range of cancers. The reasons for this have not yet been fully explored, but possible explanations include loss of immunologic control of cancer-associated viruses, chronic immune disturbance or inflammation, underlying medical conditions, and medication toxicity.
Reference: Engels EA, Pfeiffer RM, Fraumeni JF et al. Spectrum of cancer risk among US solid organ transplant recipients. JAMA. 2011;306:1891-1901.