title: Cancer Incidence among Heart, Kidney, and Liver Transplant Recipients in Taiwan.
abstract: Population-based evidence of the relative risk of cancer among heart, kidney, and liver transplant recipients from Asia is lacking. The Taiwan National Health Insurance Research Database was used to conduct a population-based cohort study of transplant recipients (n = 5396), comprising 801 heart, 2847 kidney, and 1748 liver transplant recipients between 2001 and 2012. Standardized incidence ratios and Cox regression models were used. Compared with the general population, the risk of cancer increased 3.8-fold after heart transplantation, 4.1-fold after kidney transplantation and 4.6-fold after liver transplantation. Cancer occurrence showed considerable variation according to transplanted organs. The most common cancers in all transplant patients were cancers of the head and neck, liver, bladder, and kidney and non-Hodgkin lymphoma. Male recipients had an increased risk of cancers of the head and neck and liver, and female kidney recipients had a significant risk of bladder and kidney cancer. The adjusted hazard ratio for any cancer in all recipients was higher in liver transplant recipients compared with that in heart transplant recipients (hazard ratio = 1.5, P = .04). Cancer occurrence varied considerably and posttransplant cancer screening should be performed routinely according to transplanted organ and sex.
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.|Biobank Management Center, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Kwai-Fong
authors.initials: KF
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Tsai
authors.affiliation: Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Chung-Bao
authors.initials: CB
authors.lastname: Hsieh
authors.affiliation: Division of Urology, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Sheng-Tang
authors.initials: ST
authors.lastname: Wu
authors.affiliation: Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Hung-Yen
authors.initials: HY
authors.lastname: Ke
authors.affiliation: Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Yi-Chang
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Feng-Yen
authors.initials: FY
authors.lastname: Lin
authors.affiliation: Department of Pathology, Taipei Medical University Shuang-Ho Hospital, New Taipei, Taiwan.|Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wei-Hwa
authors.initials: WH
authors.lastname: Lee
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.|Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan.|Division of Cardiovascular Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.|Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chien-Sung
authors.initials: CS
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation; D017093:Liver Failure / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery; D012306:Risk; D013624:Taiwan; D055815:Young Adult