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Cancer incidence in blood transfusion recipients.
J Natl Cancer Inst. 2007 Dec 19; 99(24):1864-74.JNCI

Abstract

BACKGROUND

Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized.

METHODS

We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided.

RESULTS

During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion.

CONCLUSIONS

The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients.

Authors+Show Affiliations

Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen South, Denmark. hhj@ssi.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18073377

Citation

Hjalgrim, Henrik, et al. "Cancer Incidence in Blood Transfusion Recipients." Journal of the National Cancer Institute, vol. 99, no. 24, 2007, pp. 1864-74.
Hjalgrim H, Edgren G, Rostgaard K, et al. Cancer incidence in blood transfusion recipients. J Natl Cancer Inst. 2007;99(24):1864-74.
Hjalgrim, H., Edgren, G., Rostgaard, K., Reilly, M., Tran, T. N., Titlestad, K. E., Shanwell, A., Jersild, C., Adami, J., Wikman, A., Gridley, G., Wideroff, L., Nyrén, O., & Melbye, M. (2007). Cancer incidence in blood transfusion recipients. Journal of the National Cancer Institute, 99(24), 1864-74.
Hjalgrim H, et al. Cancer Incidence in Blood Transfusion Recipients. J Natl Cancer Inst. 2007 Dec 19;99(24):1864-74. PubMed PMID: 18073377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cancer incidence in blood transfusion recipients. AU - Hjalgrim,Henrik, AU - Edgren,Gustaf, AU - Rostgaard,Klaus, AU - Reilly,Marie, AU - Tran,Trung Nam, AU - Titlestad,Kjell Einar, AU - Shanwell,Agneta, AU - Jersild,Casper, AU - Adami,Johanna, AU - Wikman,Agneta, AU - Gridley,Gloria, AU - Wideroff,Louise, AU - Nyrén,Olof, AU - Melbye,Mads, Y1 - 2007/12/11/ PY - 2007/12/13/pubmed PY - 2007/12/29/medline PY - 2007/12/13/entrez SP - 1864 EP - 74 JF - Journal of the National Cancer Institute JO - J Natl Cancer Inst VL - 99 IS - 24 N2 - BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco- and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/18073377/Cancer_incidence_in_blood_transfusion_recipients_ DB - PRIME DP - Unbound Medicine ER -