Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study.
Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991-2002) at Blood Centers of the Pacific (BCP), San Francisco, were linked to the California Cancer Registry (CCR, 1991-2010). Standardized incidence ratios (SIR) were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of nondonors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7%) primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64). Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66-0.74) compared with nondonor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82-1.05). Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A "healthy donor effect" on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other biomarkers of cancer.
Blood Systems Research Institute, San Francisco, CA 94118, USA.
Farnaz
F
Vahidnia
Blood Centers of the Pacific, San Francisco, CA 94118, USA.
Nora V
NV
Hirschler
University of Washington, Seattle, WA 98195, USA.
Maria
M
Agapova
Blood Centers of the Pacific, San Francisco, CA 94118, USA.
Artina
A
Chinn
Blood Systems Research Institute, San Francisco, CA 94118, USA ; Laboratory Medicine, University of California, San Francisco, CA 94143, USA.
Michael P
MP
Busch
Blood Systems Research Institute, San Francisco, CA 94118, USA ; Laboratory Medicine, University of California, San Francisco, CA 94143, USA.
Brian
B
Custer