Malignancies: pre and post transplantation strategies.
The overall incidence of cancer is increased 2-3 fold in solid organ transplant recipients compared to the general population. The increase in risk is not uniform for all malignancies, in all ages or in all regions of the world. Several cancers are greatly increased, many are increased 2-4 fold and others do not appear to be increased at all. The pattern of increase is similar to patients with acquired immunodeficiency syndrome and those cancers most increased are associated with viral infections. These observations support the concept that much of the increased risk is from immunosuppression. Nonetheless there are differences between specific organ groups that deserve further examination. Those with advanced organ failure are also at increased risk for certain malignancies, which suggest either organ damage per se may pre-dispose to cancers or there are exposures to carcinogens in common. The purpose of this review to examine cancer incidence and mortality in solid organ transplantation and the role of pre transplant screening and post-transplant surveillance to reduce the burden of disease and improve patient outcomes. This review will focus on cancers that are common, associated with significant case fatality rates and have potential screening strategies to reduce burden of disease.
Multiorgan Transplant Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Meteb
M
AlBugami
Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: Bryce.kiberd@dal.ca.
Bryce
B
Kiberd
D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D016377:Organ Transplantation / Q000009:adverse effects / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis
D007166:Immunosuppressive Agents