title: Long-Term Risk of Cancer in Survivors of Pediatric ESRD.
abstract: OBJECTIVE
  ESRD is associated with an increased risk of malignancies. We analyzed the incidence of cancer in patients with pediatric ESRD after long-term follow-up.
  
  
  METHODS
  All Dutch patients born before 1979 who were transplanted at age <15 years old in 1972-1992 were followed until 2010. We explored type and incidence of malignancies in patients compared with the general population using the National Cancer Registry.
  
  
  RESULTS
  After a median of 25.3 years (1.3-37.8) of transplantation and at a median age of 33.5 years old (11.0-49.0), 105 primary malignancies had occurred in 54 of 249 patients. Among them, cutaneous squamous cell carcinoma was most frequent. Patients ages 25-30 years old had developed 16.5 times (95% confidence interval, 7.9 to 34.6) as many de novo tumors and 991 times (95% confidence interval, 313 to 3137) as many de novo cutaneous squamous cell carcinomas as their general population counterparts; in survivors ages 45-50 years old, these numbers were 81.5 (95% confidence interval, 50.7 to 131.1) and 2610 (95% confidence interval, 1596 to 4267), respectively. Cumulative incidence competing risk analysis showed that, after 30 years of transplantation, 41% of the survivors had developed cancer; 31% had developed a second de novo cancer <1 year after initial cancer diagnosis.
  
  
  CONCLUSIONS
  Cancer is highly prevalent among patients with pediatric ESRD after 25.3 years of transplantation, with a high rate of recurrence.
authors.affiliation: Department of Paediatric Nephrology, Emma Children's Hospital and.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ploos van Amstel
authors.affiliation: Department of Paediatric Nephrology, Emma Children's Hospital and J.L.Vogelzang@amc.uva.nl.
authors.forename: Judith L
authors.initials: JL
authors.lastname: Vogelzang
authors.affiliation: Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands; and.
authors.forename: Marcus V
authors.initials: MV
authors.lastname: Starink
authors.affiliation: European Renal Association-European Dialysis and Transplant Association, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.affiliation: Department of Paediatric Nephrology, Emma Children's Hospital and.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D017582:Renal Replacement Therapy / Q000009:adverse effects* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D055815:Young Adult
keywords: cancer; carcinoma; child; end-stage renal disease; follow-up studies; kidney failure, chronic; neoplasms; renal insufficiency, chronic; renal transplantation; squamous cell; survivors