Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;16(12):3479-3489.
doi: 10.1111/ajt.13862. Epub 2016 Jun 23.

Risk of Renal Cell Carcinoma Among Kidney Transplant Recipients in the United States

S Karami  1 , E L Yanik  1 , L E Moore  1 , R M Pfeiffer  1 , G Copeland  2 , L Gonsalves  3 , B Y Hernandez  4 , C F Lynch  5 , K Pawlish  6 , E A Engels  1
Affiliations

Risk of Renal Cell Carcinoma Among Kidney Transplant Recipients in the United States

S Karami et al. Am J Transplant. 2016 Dec.

Abstract

Renal cell carcinoma (RCC) is a common malignancy following kidney transplantation. We describe RCC risk and examine RCC risk factors among US kidney recipients (1987-2010). The Transplant Cancer Match Study links the US transplant registry with 15 cancer registries. Standardized incidence ratios (SIRs) were used to compare RCC risk (overall and for clear cell [ccRCC] and papillary subtypes) to the general population. Associations with risk factors were assessed using Cox models. We identified 683 RCCs among 116 208 kidney recipients. RCC risk was substantially elevated compared with the general population (SIR 5.68, 95% confidence interval 5.27-6.13), especially for papillary RCC (SIR 13.3 versus 3.98 for ccRCC). Among kidney recipients, RCC risk was significantly elevated for blacks compared to whites (hazard ratio [HR] 1.50) and lower in females than males (HR 0.56). RCC risk increased with prolonged dialysis preceding transplantation (p-trend < 0.0001). Risk was variably associated for RCC subtypes with some medical conditions that were indications for transplantation: ccRCC risk was reduced with polycystic kidney disease (HR 0.54), and papillary RCC was increased with hypertensive nephrosclerosis (HR 2.02) and vascular diseases (HR 1.86). In conclusion, kidney recipients experience substantially elevated risk of RCC, especially for papillary RCC, and multiple factors contribute to these cancers.

Keywords: cancer/malignancy/neoplasia: risk factors; epidemiology; health services and outcomes research; kidney transplantation/nephrology.

PubMed Disclaimer

Conflict of interest statement

Disclosure

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Figures

Figure 1
Figure 1. Hazard of RCC as a function of time since kidney transplant
Results are shown for: (A) RCC overall, (B) according to histologic subtypes (clear cell and papillary RCC), (C) according to stage (local and regional/distant RCC), and (D) according to grade (low and high grade). Hazards were estimated using cubic B-splines. The vertical axis shows the hazard in units of “per 1000 person-years”. RCC, renal cell carcinoma.
Figure 2
Figure 2. Cumulative incidence of RCC, overall and by histology
Results are shown for RCC overall (dashed black and gray line), clear cell RCC (gray line), and papillary RCC (black line). Note that the vertical axis is truncated and reaches a maximum of 3%. RCC, renal cell carcinoma.
See this image and copyright information in PMC

Comment in

References

    1. National Kidney Foundation. [2015 Jul 10];ORGAN DONATION AND TRANSPLANTATION STATISTICS. [Internet] Available from: http://www.kidney.org/news/newsroom/factsheets/Organ-Donation-and-Transp....
    1. U.S. Department of Health & Human Services. [2015 Jul 10];Scientific Registry of Transplant Recipients 2012 Annual Data Report. [Internet] Available from: http://srtr.transplant.hrsa.gov/annual_reports/2012/Default.aspx.
    1. Collett D, Mumford L, Banner NR, Neuberger J, Watson C. Comparison of the incidence of malignancy in recipients of different types of organ: A UK registry audit. Am J Transplant. 2010;10:1889–1896. - PubMed
    1. Vajdic CM, McDonald SP, McCredie MRE, van Leeuwen MT, Stewart JH, Law M, et al. Cancer incidence before and after kidney transplantation. JAMA. 2006;296:2823–2831. - PubMed
    1. Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet. 2007;370:59–67. - PubMed

Publication types

MeSH terms