Malignant disease may re-emerge following SOT among cancer survivors

Solid organ transplant (SOT) recipients with a history of cancer are at increased risk of post-transplant cancer, especially the same type of cancer, according to a study.

Researchers used linked data from the US Scientific Registry of Transplant Recipients and 34 population-based cancer registries. They identified 520,424 SOT recipients (median age at transplant 52 years, 62.6 percent male) for inclusion in the analysis.

Of the SOT recipients, 58 percent received a kidney, 21.2 percent received a liver, 8.9 percent received a heart, and 6 percent received a lung. These recipients were followed for a median of 6.1 years after transplant. The median interval from pretransplant cancer diagnosis to transplant procedure was 1.15 years, and the median interval from transplant procedure to post-transplant cancer diagnosis was 5.64 years.

SOT recipients with specific types of pretransplant cancer were found to be at increased risk of the same type of cancer after transplant. These cancers included breast (incidence rate ratio [IRR], 3.71, 95 percent confidence interval [CI], 3.04–4.48), melanoma of the skin (IRR, 10.4, 95 percent CI, 7.43–14.1), lung (IRR, 3.65, 95 percent CI, 2.67–4.86), kidney (IRR, 2.34, 95 percent CI, 1.94–2.79), urinary bladder (IRR, 3.72, 95 percent CI, 2.44–5.39), liver (IRR, 1.73, 95 percent CI, 1.39–2.14), and colorectum (IRR, 2.38, 95 percent CI, 1.61–3.37).

Other significant associations included post-transplant lung cancer (IRR, 1.63, 95 percent CI, 1.48–1.80) or prostate cancer (IRR, 1.71, 95 percent CI, 1.53–1.92) among SOT recipients with pretransplant liver cancer, post-transplant lung cancer (IRR, 2.55, 95 percent CI, 1.93–3.29) among recipients with pretransplant urinary bladder cancer, post-transplant thyroid cancer (IRR, 2.87, 95 percent CI, 1.87–4.17) among recipients with pretransplant kidney cancer, and post-transplant pancreatic cancer (IRR, 8.56, 95 percent CI, 3.66–16.7) among recipients with pretransplant intrahepatic bile duct cancer.

The findings underscore the importance of targeted cancer prevention and screening for SOT recipients who have survived a cancer before a transplant.