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Abstract: FR-PO1143

Incident Cancer After Kidney Transplantation in South Korea: A Nationwide-Population Based Study

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Yu, Mi-yeon, Hanyang University Guri Hospital, Gyeonggido, Korea (the Republic of)
  • Park, Sehoon, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Ji Eun, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yong Chul, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Cancer is one of the most common cause of death with functioning graft in kidney transplantation (KT) patients. In this study, we aimed to investigate post-KT cancer incidence using a nationwide data compared with end-stage renal disease (ESRD) control and general population (GP).

Methods

We included incident KT recipients aged over 20 years without previous cancer history using a Nationwide Health Insurance Database of South Korea from January 1, 2007, to December 31, 2015. We analyzed the incidence rate (IR) per 1000 patient-year of cancer in KT recipients compared with ESRD and GP cohorts which were extracted after matching by age, sex, and inclusion year.

Results

A total of 10,203 KT recipients were analyzed with matched ESRD and GP controls. Their mean age was 45.2±10.7 years and 60.3% were men. Economic status of KT recipients was lower than GP but better than ESRD control. Combined diabetes or hypertension of KT recipients was similar to ESRD control but higher than GP. Incident cancer IR in KT recipients (8.63/1000 patient-year) was higher than that of GP (5.28/1000 patient-year), but lower than ESRD controls (12.27/1000 patient-year). In overall, KT recipients had 65.3% higher risk of incident cancer, whereas ESRD patients were at 2.4-fold higher risk of cancer development than GP. Among various cancer types, KT recipients showed higher risk of urinary tract cancer (HR 3.01, 95% CI 1.45-6.22), non-Hodgkin lymphoma (HR 3.97, 95% CI 1.14-13.79), and skin cancer (HR 4.33, 95% CI 1.46-12.83), whereas ESRD patients revealed higher risk of urinary tract cancer, and leukemia compared with GP. We can show a similar trend of cancer IR according cancer type within 5 years after KT, but after then, only stomach cancer IR in KT patients (0.88/1000 patient-year), was higher than that of GP (0.25/1000 patient-year).

Conclusion

In this study, we found that KT recipients had higher risk of incident cancer than GP, although this did not exceed that of ESRD patients. It is suggested that KT recipients should be monitored on the occurrence of urinary tract cancer, skin cancer and non-Hodgkin lymphoma more meticulously than GP, especially, within 5 years after KT. Gastroscopy should be recommended for all KT recipients regardless of the post KT duration.