title: Risk of Renal Cell Carcinoma Among Kidney Transplant Recipients in the United States.
abstract: Renal cell carcinoma (RCC) is a common malignancy following kidney transplantation. We describe RCC risk and examine RCC risk factors among US kidney recipients (1987-2010). The Transplant Cancer Match Study links the US transplant registry with 15 cancer registries. Standardized incidence ratios (SIRs) were used to compare RCC risk (overall and for clear cell [ccRCC] and papillary subtypes) to the general population. Associations with risk factors were assessed using Cox models. We identified 683 RCCs among 116 208 kidney recipients. RCC risk was substantially elevated compared with the general population (SIR 5.68, 95% confidence interval 5.27-6.13), especially for papillary RCC (SIR 13.3 versus 3.98 for ccRCC). Among kidney recipients, RCC risk was significantly elevated for blacks compared to whites (hazard ratio [HR] 1.50) and lower in females than males (HR 0.56). RCC risk increased with prolonged dialysis preceding transplantation (p-trend < 0.0001). Risk was variably associated for RCC subtypes with some medical conditions that were indications for transplantation: ccRCC risk was reduced with polycystic kidney disease (HR 0.54), and papillary RCC was increased with hypertensive nephrosclerosis (HR 2.02) and vascular diseases (HR 1.86). In conclusion, kidney recipients experience substantially elevated risk of RCC, especially for papillary RCC, and multiple factors contribute to these cancers.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD.
authors.forename: S
authors.initials: S
authors.lastname: Karami
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD.
authors.forename: E L
authors.initials: EL
authors.lastname: Yanik
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD.
authors.forename: L E
authors.initials: LE
authors.lastname: Moore
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD.
authors.forename: R M
authors.initials: RM
authors.lastname: Pfeiffer
authors.affiliation: Michigan Cancer Surveillance Program, Michigan Department of Community Health, Lansing, MI.
authors.forename: G
authors.initials: G
authors.lastname: Copeland
authors.affiliation: Connecticut Department of Public Health, Hartford, CT.
authors.forename: L
authors.initials: L
authors.lastname: Gonsalves
authors.affiliation: University of Hawaii Cancer Center, Honolulu, HI.
authors.forename: B Y
authors.initials: BY
authors.lastname: Hernandez
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
authors.forename: C F
authors.initials: CF
authors.lastname: Lynch
authors.affiliation: New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, Trenton, NJ.
authors.forename: K
authors.initials: K
authors.lastname: Pawlish
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD.
authors.forename: E A
authors.initials: EA
authors.lastname: Engels
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000601:surgery; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: cancer/malignancy/neoplasia: risk factors; epidemiology; health services and outcomes research; kidney transplantation/nephrology