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Liver transplantation and subsequent risk of cancer: findings from a Canadian cohort study.
Liver Transpl. 2008 Nov; 14(11):1588-97.LT

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.

Authors+Show Affiliations

Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18975293

Citation

Jiang, Ying, et al. "Liver Transplantation and Subsequent Risk of Cancer: Findings From a Canadian Cohort Study." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 14, no. 11, 2008, pp. 1588-97.
Jiang Y, Villeneuve PJ, Fenton SS, et al. Liver transplantation and subsequent risk of cancer: findings from a Canadian cohort study. Liver Transpl. 2008;14(11):1588-97.
Jiang, Y., Villeneuve, P. J., Fenton, S. S., Schaubel, D. E., Lilly, L., & Mao, Y. (2008). Liver transplantation and subsequent risk of cancer: findings from a Canadian cohort study. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 14(11), 1588-97. https://doi.org/10.1002/lt.21554
Jiang Y, et al. Liver Transplantation and Subsequent Risk of Cancer: Findings From a Canadian Cohort Study. Liver Transpl. 2008;14(11):1588-97. PubMed PMID: 18975293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver transplantation and subsequent risk of cancer: findings from a Canadian cohort study. AU - Jiang,Ying, AU - Villeneuve,Paul J, AU - Fenton,Stanley S A, AU - Schaubel,Douglas E, AU - Lilly,Les, AU - Mao,Yang, PY - 2008/11/1/pubmed PY - 2009/4/28/medline PY - 2008/11/1/entrez SP - 1588 EP - 97 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl VL - 14 IS - 11 N2 - 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. SN - 1527-6473 UR - https://www.unboundmedicine.com/medline/citation/18975293/Liver_transplantation_and_subsequent_risk_of_cancer:_findings_from_a_Canadian_cohort_study_ L2 - https://doi.org/10.1002/lt.21554 DB - PRIME DP - Unbound Medicine ER -