title: Cumulative incidence of cancer after solid organ transplantation.
abstract: BACKGROUND
  Solid organ transplantation recipients have elevated cancer incidence. Estimates of absolute cancer risk after transplantation can inform prevention and screening.
  
  
  METHODS
  The Transplant Cancer Match Study links the US transplantation registry with 14 state/regional cancer registries. The authors used nonparametric competing risk methods to estimate the cumulative incidence of cancer after transplantation for 2 periods (1987-1999 and 2000-2008). For recipients from 2000 to 2008, the 5-year cumulative incidence, stratified by organ, sex, and age at transplantation, was estimated for 6 preventable or screen-detectable cancers. For comparison, the 5-year cumulative incidence was calculated for the same cancers in the general population at representative ages using Surveillance, Epidemiology, and End Results data.
  
  
  RESULTS
  Among 164,156 recipients, 8520 incident cancers were identified. The absolute cancer risk was slightly higher for recipients during the period from 2000 to 2008 than during the period from 1987 to 1999 (5-year cumulative incidence: 4.4% vs. 4.2%; P = .006); this difference arose from the decreasing risk of competing events (5-year cumulative incidence of death, graft failure, or retransplantation: 26.6% vs. 31.9%; P < .001). From 2000 to 2008, the 5-year cumulative incidence of non-Hodgkin lymphoma was highest at extremes of age, especially in thoracic organ recipients (ages 0-34 years: range, 1.74%-3.28%; aged >50 years; range, 0.36%-2.22%). For recipients aged >50 years, the 5-year cumulative incidence was higher for colorectal cancer (range, 0.33%-1.94%) than for the general population at the recommended screening age (aged 50 years: range, 0.25%-0.33%). For recipients aged >50 years, the 5-year cumulative incidence was high for lung cancer among thoracic organ recipients (range, 1.16%-3.87%) and for kidney cancer among kidney recipients (range, 0.53%-0.84%). The 5-year cumulative incidence for prostate cancer and breast cancer was similar or lower in transplantation recipients than at the recommended ages of screening in the general population.
  
  
  CONCLUSIONS
  Subgroups of transplantation recipients have a high absolute risk of some cancers and may benefit from targeted prevention or screening.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20852, USA.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Hall
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D016377:Organ Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D014481:United States; D055815:Young Adult
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