title: Increased cancer risk after liver transplantation: a population-based study.
abstract: OBJECTIVE
  Development of de novo malignancies emerges as a serious long term complication after liver transplantation.
  
  
  METHODS
  We reviewed the medical records of 174 adult one-year survivors for de novo malignancies. The observed cancer rates were compared with the expected cancer rates in the Dutch population.
  
  
  RESULTS
  Twenty-one of the 174 patients developed 23 malignancies (12%). Skin and lip cancer accounted for 12 of the 23 malignancies (52%). Only one patient had a B-cell lymphoma. The cumulative risk for de novo malignancy was 6, 20, and 55% at 5, 10, and 15 years after transplantation, respectively. The overall relative risk (RR) as compared with the general population was 4.3 (95% confidence interval 2.4-7.1). Significantly increased RRs were observed for non-melanoma skin cancer (RR 70.0), non-skin solid cancer (RR 2.7), renal cell cancer (RR 30.0), and colon cancer (RR 12.5). Multivariate analysis showed that an age > 40 years and pretransplant use of immunosuppression were significant risk factors.
  
  
  CONCLUSIONS
  An increased risk of cancer exists after liver transplantation, for both for skin/lip cancer, and other solid tumors. Older age and the use of immunosuppression are risk factors.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Groningen, The Netherlands. e.b.haagsma@int.azg.nl
authors.forename: E B
authors.initials: EB
authors.lastname: Haagsma
authors.forename: V E
authors.initials: VE
authors.lastname: Hagens
authors.forename: M
authors.initials: M
authors.lastname: Schaapveld
authors.forename: A P
authors.initials: AP
authors.lastname: van den Berg
authors.forename: E G
authors.initials: EG
authors.lastname: de Vries
authors.forename: I J
authors.initials: IJ
authors.lastname: Klompmaker
authors.forename: M J
authors.initials: MJ
authors.lastname: Slooff
authors.forename: P L
authors.initials: PL
authors.lastname: Jansen
mesh_terms: D000328:Adult; D000367:Age Factors; D003110:Colonic Neoplasms / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000209:etiology; D008048:Lip Neoplasms / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents