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. 2023 Feb 20;15(4):1347.
doi: 10.3390/cancers15041347.

Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period

Pierluca Piselli  1 , Diego Serraino  2 , Claudia Cimaglia  1 , Lucrezia Furian  3 , Luigi Biancone  4 , Ghil Busnach  5 , Nicola Bossini  6 , Paola Todeschini  7 , Maurizio Iaria  8 , Franco Citterio  9 , Mariarosaria Campise  10 , Massimiliano Veroux  11 , Giuseppe Tisone  12 , Vincenzo Cantaluppi  13 , Margherita Mangino  14 , Simona Simone  15 , Davide Argiolas  16 , Andrea Ambrosini  17 , Francesco Pisani  18 , Flavia Caputo  19 , Martina Taborelli  2 ; Italian Transplant and Cancer Cohort Study
Affiliations

Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period

Pierluca Piselli et al. Cancers (Basel). .

Abstract

This cohort study examined 25-year variations in cancer incidence among 11,418 Italian recipients of kidney transplantation (KT) from 17 Italian centers. Cancer incidence was examined over three periods (1997-2004; 2005-2012; and 2013-2021) by internal (Incidence rate ratio-IRR) and external (standardized incidence ratios-SIR) comparisons. Poisson regression was used to assess trends. Overall, 1646 post-transplant cancers were diagnosed, with incidence rates/1000 person-years ranging from 15.5 in 1997-2004 to 21.0 in 2013-2021. Adjusted IRRs showed a significant reduction in incidence rates across periods for all cancers combined after exclusion of nonmelanoma skin cancers (IRR = 0.90, 95% confidence interval-CI: 0.76-1.07 in 2005-2012; IRR = 0.72, 95% CI: 0.60-0.87 in 2013-2021 vs. 1997-2004; Ptrend < 0.01). In site-specific analyses, however, significant changes in incidence rates were observed only for Kaposi's sarcoma (KS; IRR = 0.37, 95% CI: 0.24-0.57 in 2005-2012; IRR = 0.09, 95% CI: 0.04-0.18 in 2013-2021; Ptrend < 0.01). As compared to the general population, the overall post-transplant cancer risk in KT recipients was elevated, with a decreasing magnitude over time (SIR = 2.54, 95% CI: 2.26-2.85 in 1997-2004; SIR = 1.99, 95% CI: 1.83-2.16 in 2013-2021; Ptrend < 0.01). A decline in SIRs was observed specifically for non-Hodgkin lymphoma and KS, though only the KS trend retained statistical significance after adjustment. In conclusion, apart from KS, no changes in the incidence of other cancers over time were observed among Italian KT recipients.

Keywords: Italy; cohort study; immunosuppression; kidney transplant; trend; virus-related malignancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of kidney transplant (KT) recipients selection.
Figure 2
Figure 2
Standardized incidence ratios (SIR) and 95% confidence intervals (CI) for major cancer sites. Sites/types with <4 observed cases are not shown in figure. Abbreviations: NHL, non-Hodgkin lymphoma; NMSC, nonmelanoma skin cancer; obs/exp, observed/expected; PTLD, post-transplant lymphoproliferative diseases. Bold text indicates results that are statistically significant (p < 0.05).
See this image and copyright information in PMC

References

    1. Friman T.K., Jäämaa-Holmberg S., Åberg F., Helanterä I., Halme M., Pentikäinen M.O., Nordin A., Lemström K.B., Jahnukainen T., Räty R., et al. Cancer risk and mortality after solid organ transplantation: A population-based 30-year cohort study in Finland. Int. J. Cancer. 2022;150:1779–1791. doi: 10.1002/ijc.33934. - DOI - PMC - PubMed
    1. Acuna S.A. Etiology of increased cancer incidence after solid organ transplantation. Transplant. Rev. 2018;32:218–224. doi: 10.1016/j.trre.2018.07.001. - DOI - PubMed
    1. Engels E.A., Pfeiffer R.M., Fraumeni J.F., Jr., Kasiske B.L., Israni A.K., Snyder J.J., Wolfe R.A., Goodrich N.P., Bayakly A.R., Clarke C.A., et al. Spectrum of Cancer Risk Among US Solid Organ Transplant Recipients. JAMA. 2011;306:1891–1901. doi: 10.1001/jama.2011.1592. - DOI - PMC - PubMed
    1. Au E., Wong G., Chapman J.R. Cancer in kidney transplant recipients. Nat. Rev. Nephrol. 2018;14:508–520. doi: 10.1038/s41581-018-0022-6. - DOI - PubMed
    1. Piselli P., Serraino D., Segoloni G.P., Sandrini S., Piredda G.B., Scolari M.P., Rigotti P., Busnach G., Messa P., Donati D., et al. Risk of de novo cancers after transplantation: Results from a cohort of 7217 kidney transplant recipients, Italy 1997–2009. Eur. J. Cancer. 2013;49:336–344. doi: 10.1016/j.ejca.2012.09.013. - DOI - PubMed