Time on dialysis and cancer risk after kidney transplantation

G. Wong, R.M. Turner, J.R. Chapman, M. Howell, Wai Lim, A.C. Webster, J.C. Craig

    Research output: Contribution to journalArticle

    28 Citations (Scopus)

    Abstract

    BACKGROUND: Increasing time on dialysis is an established risk factor for certain cancer types for patients on dialysis, but the relationship between the time on dialysis and cancer risk after transplantation is unclear. We aimed to determine if the length of time on maintenance dialysis before the first kidney transplantation was associated with the risk of site-specific and overall incident cancers after transplantation. METHODS: Using the Australia and New Zealand Dialysis and Transplant Registry, we assessed the association between both all cancers (except for nonmelanocytic skin cancers) and site-specific cancer incidence and the duration on dialysis before the first transplantation using adjusted Cox proportional hazards and competing risk models. RESULTS: Over a median follow-up of 4.4 years (interquartile range, 1.7-7.7 years), the total cumulative incidence of all cancers after the first kidney transplantation was 15.0 per 1000 patient-years. There was a linear relationship between the duration of dialysis and the risk of cancer after transplantation (Ptrend=0.02). The excess risks for lung and urinary tract cancers were highest among recipients who had been on dialysis for the longest duration before transplantation (adjusted hazard ratio [95% confidence interval], 3.32 [1.00-11.4]; P=0.05 and 2.57 [1.33-4.95]; P=0.005, respectively). CONCLUSION: Increasing time on dialysis is a significant risk factor for common solid organ cancers, such as lung cancer, and urinary tract cancers in kidney transplant recipients, irrespective of age. Strategies to improve cancer surveillance among recipients who had been on dialysis for a longer time may be warranted. © 2012 Lippincott Williams & Wilkins.
    Original languageEnglish
    Pages (from-to)114-121
    JournalTransplantation
    Volume95
    Issue number1
    DOIs
    Publication statusPublished - 2013

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    Kidney Transplantation
    Dialysis
    Neoplasms
    Urologic Neoplasms
    Transplantation
    Kidney Neoplasms
    Incidence
    Skin Neoplasms
    New Zealand
    Registries
    Lung Neoplasms
    Maintenance
    Confidence Intervals
    Transplants
    Lung

    Cite this

    Wong, G., Turner, R. M., Chapman, J. R., Howell, M., Lim, W., Webster, A. C., & Craig, J. C. (2013). Time on dialysis and cancer risk after kidney transplantation. Transplantation, 95(1), 114-121. https://doi.org/10.1097/TP.0b013e31827743b4
    Wong, G. ; Turner, R.M. ; Chapman, J.R. ; Howell, M. ; Lim, Wai ; Webster, A.C. ; Craig, J.C. / Time on dialysis and cancer risk after kidney transplantation. In: Transplantation. 2013 ; Vol. 95, No. 1. pp. 114-121.
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    title = "Time on dialysis and cancer risk after kidney transplantation",
    abstract = "BACKGROUND: Increasing time on dialysis is an established risk factor for certain cancer types for patients on dialysis, but the relationship between the time on dialysis and cancer risk after transplantation is unclear. We aimed to determine if the length of time on maintenance dialysis before the first kidney transplantation was associated with the risk of site-specific and overall incident cancers after transplantation. METHODS: Using the Australia and New Zealand Dialysis and Transplant Registry, we assessed the association between both all cancers (except for nonmelanocytic skin cancers) and site-specific cancer incidence and the duration on dialysis before the first transplantation using adjusted Cox proportional hazards and competing risk models. RESULTS: Over a median follow-up of 4.4 years (interquartile range, 1.7-7.7 years), the total cumulative incidence of all cancers after the first kidney transplantation was 15.0 per 1000 patient-years. There was a linear relationship between the duration of dialysis and the risk of cancer after transplantation (Ptrend=0.02). The excess risks for lung and urinary tract cancers were highest among recipients who had been on dialysis for the longest duration before transplantation (adjusted hazard ratio [95{\%} confidence interval], 3.32 [1.00-11.4]; P=0.05 and 2.57 [1.33-4.95]; P=0.005, respectively). CONCLUSION: Increasing time on dialysis is a significant risk factor for common solid organ cancers, such as lung cancer, and urinary tract cancers in kidney transplant recipients, irrespective of age. Strategies to improve cancer surveillance among recipients who had been on dialysis for a longer time may be warranted. {\circledC} 2012 Lippincott Williams & Wilkins.",
    author = "G. Wong and R.M. Turner and J.R. Chapman and M. Howell and Wai Lim and A.C. Webster and J.C. Craig",
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    Wong, G, Turner, RM, Chapman, JR, Howell, M, Lim, W, Webster, AC & Craig, JC 2013, 'Time on dialysis and cancer risk after kidney transplantation' Transplantation, vol. 95, no. 1, pp. 114-121. https://doi.org/10.1097/TP.0b013e31827743b4

    Time on dialysis and cancer risk after kidney transplantation. / Wong, G.; Turner, R.M.; Chapman, J.R.; Howell, M.; Lim, Wai; Webster, A.C.; Craig, J.C.

    In: Transplantation, Vol. 95, No. 1, 2013, p. 114-121.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Time on dialysis and cancer risk after kidney transplantation

    AU - Wong, G.

    AU - Turner, R.M.

    AU - Chapman, J.R.

    AU - Howell, M.

    AU - Lim, Wai

    AU - Webster, A.C.

    AU - Craig, J.C.

    PY - 2013

    Y1 - 2013

    N2 - BACKGROUND: Increasing time on dialysis is an established risk factor for certain cancer types for patients on dialysis, but the relationship between the time on dialysis and cancer risk after transplantation is unclear. We aimed to determine if the length of time on maintenance dialysis before the first kidney transplantation was associated with the risk of site-specific and overall incident cancers after transplantation. METHODS: Using the Australia and New Zealand Dialysis and Transplant Registry, we assessed the association between both all cancers (except for nonmelanocytic skin cancers) and site-specific cancer incidence and the duration on dialysis before the first transplantation using adjusted Cox proportional hazards and competing risk models. RESULTS: Over a median follow-up of 4.4 years (interquartile range, 1.7-7.7 years), the total cumulative incidence of all cancers after the first kidney transplantation was 15.0 per 1000 patient-years. There was a linear relationship between the duration of dialysis and the risk of cancer after transplantation (Ptrend=0.02). The excess risks for lung and urinary tract cancers were highest among recipients who had been on dialysis for the longest duration before transplantation (adjusted hazard ratio [95% confidence interval], 3.32 [1.00-11.4]; P=0.05 and 2.57 [1.33-4.95]; P=0.005, respectively). CONCLUSION: Increasing time on dialysis is a significant risk factor for common solid organ cancers, such as lung cancer, and urinary tract cancers in kidney transplant recipients, irrespective of age. Strategies to improve cancer surveillance among recipients who had been on dialysis for a longer time may be warranted. © 2012 Lippincott Williams & Wilkins.

    AB - BACKGROUND: Increasing time on dialysis is an established risk factor for certain cancer types for patients on dialysis, but the relationship between the time on dialysis and cancer risk after transplantation is unclear. We aimed to determine if the length of time on maintenance dialysis before the first kidney transplantation was associated with the risk of site-specific and overall incident cancers after transplantation. METHODS: Using the Australia and New Zealand Dialysis and Transplant Registry, we assessed the association between both all cancers (except for nonmelanocytic skin cancers) and site-specific cancer incidence and the duration on dialysis before the first transplantation using adjusted Cox proportional hazards and competing risk models. RESULTS: Over a median follow-up of 4.4 years (interquartile range, 1.7-7.7 years), the total cumulative incidence of all cancers after the first kidney transplantation was 15.0 per 1000 patient-years. There was a linear relationship between the duration of dialysis and the risk of cancer after transplantation (Ptrend=0.02). The excess risks for lung and urinary tract cancers were highest among recipients who had been on dialysis for the longest duration before transplantation (adjusted hazard ratio [95% confidence interval], 3.32 [1.00-11.4]; P=0.05 and 2.57 [1.33-4.95]; P=0.005, respectively). CONCLUSION: Increasing time on dialysis is a significant risk factor for common solid organ cancers, such as lung cancer, and urinary tract cancers in kidney transplant recipients, irrespective of age. Strategies to improve cancer surveillance among recipients who had been on dialysis for a longer time may be warranted. © 2012 Lippincott Williams & Wilkins.

    U2 - 10.1097/TP.0b013e31827743b4

    DO - 10.1097/TP.0b013e31827743b4

    M3 - Article

    VL - 95

    SP - 114

    EP - 121

    JO - Transplantation

    JF - Transplantation

    SN - 0041-1337

    IS - 1

    ER -