Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study

Henrik Benoni; Sandra Eloranta; Dag O. Dahle; My H.S. Svensson; Arno Nordin; Jan Carstens; Geir Mjøen; Ilkka Helanterä; Vivan Hellström; Gunilla Enblad; Eero Pukkala; Søren S. Sørensen; Marko Lempinen; Karin E. Smedby

doi:10.1111/tri.13734

Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study

Henrik Benoni^*
, Sandra Eloranta
, Dag O. Dahle
, My H.S. Svensson
, Arno Nordin
, Jan Carstens
, Geir Mjøen
, Ilkka Helanterä
, Vivan Hellström
, Gunilla Enblad
, Eero Pukkala
, Søren S. Sørensen
, Marko Lempinen
, Karin E. Smedby

^*Corresponding author for this work

Health Sciences

Research output: Contribution to journal › Article › Scientific › peer-review

14 Citations (Scopus)

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Abstract

Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2–3.4). The AER of any cancer was 1560 cases (95% CI: 1468–1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778–901), non-Hodgkin lymphoma (145, 95% CI: 119–174), lung cancer (126, 95% CI: 98.2–149), and kidney cancer (122, 95% CI: 98.0–149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6–8.6%) and 16.8% (95% CI: 16.0–17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.

Original language	English
Pages (from-to)	1700-1710
Number of pages	11
Journal	Transplant International
Volume	33
Issue number	12
DOIs	https://doi.org/10.1111/tri.13734
Publication status	Published - 2020
Publication type	A1 Journal article-refereed

Funding

This study was supported by the Strategic research program in epidemiology at Karolinska Institutet, and by ScandiaTransplant. Novartis provided funding for meetings and travel during the planning phase of the study. We thank ScandiaTransplant and the Renal Registries of respective country for access to data. The study has also used data from the Cancer Registries of Norway, Sweden, Denmark, and Finland. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway, Sweden, Denmark, or Finland is intended nor should be inferred.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

cancer
incidence
malignancy
risk
transplantation

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Transplantation

Access to Document

10.1111/tri.13734Licence: CC BY-NC-ND

relative_and_absolute_2020
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Final published version, 630 KBLicence: CC BY-NC-ND

http://urn.fi/URN:NBN:fi:tuni-202104203176Licence: CC BY-NC-ND

Cite this

Benoni, H., Eloranta, S., Dahle, D. O., Svensson, M. H. S., Nordin, A., Carstens, J., Mjøen, G., Helanterä, I., Hellström, V., Enblad, G., Pukkala, E., Sørensen, S. S., Lempinen, M., & Smedby, K. E. (2020). Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study. Transplant International, 33(12), 1700-1710. https://doi.org/10.1111/tri.13734

@article{6af5814092a34e6e95a24cd36ae71856,

title = "Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study",

abstract = "Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95\% confidence interval [CI]: 3.2–3.4). The AER of any cancer was 1560 cases (95\% CI: 1468–1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95\% CI: 778–901), non-Hodgkin lymphoma (145, 95\% CI: 119–174), lung cancer (126, 95\% CI: 98.2–149), and kidney cancer (122, 95\% CI: 98.0–149). The five- and ten-year cumulative incidence of any cancer was 8.1\% (95\% CI: 7.6–8.6\%) and 16.8\% (95\% CI: 16.0–17.6\%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.",

keywords = "cancer, incidence, malignancy, risk, transplantation",

author = "Henrik Benoni and Sandra Eloranta and Dahle, \{Dag O.\} and Svensson, \{My H.S.\} and Arno Nordin and Jan Carstens and Geir Mj{\o}en and Ilkka Helanter{\"a} and Vivan Hellstr{\"o}m and Gunilla Enblad and Eero Pukkala and S{\o}rensen, \{S{\o}ren S.\} and Marko Lempinen and Smedby, \{Karin E.\}",

note = "Funding Information: This study was supported by the Strategic research program in epidemiology at Karolinska Institutet, and by ScandiaTransplant. Novartis provided funding for meetings and travel during the planning phase of the study. We thank ScandiaTransplant and the Renal Registries of respective country for access to data. The study has also used data from the Cancer Registries of Norway, Sweden, Denmark, and Finland. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway, Sweden, Denmark, or Finland is intended nor should be inferred. Publisher Copyright: {\textcopyright} 2020 The Authors. Transplant International published by John Wiley \& Sons Ltd on behalf of Steunstichting ESOT Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

doi = "10.1111/tri.13734",

language = "English",

volume = "33",

pages = "1700--1710",

number = "12",

}

Benoni, H, Eloranta, S, Dahle, DO, Svensson, MHS, Nordin, A, Carstens, J, Mjøen, G, Helanterä, I, Hellström, V, Enblad, G, Pukkala, E, Sørensen, SS, Lempinen, M & Smedby, KE 2020, 'Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study', Transplant International, vol. 33, no. 12, pp. 1700-1710. https://doi.org/10.1111/tri.13734

TY - JOUR

T1 - Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study

AU - Benoni, Henrik

AU - Eloranta, Sandra

AU - Dahle, Dag O.

AU - Svensson, My H.S.

AU - Nordin, Arno

AU - Carstens, Jan

AU - Mjøen, Geir

AU - Helanterä, Ilkka

AU - Hellström, Vivan

AU - Enblad, Gunilla

AU - Pukkala, Eero

AU - Sørensen, Søren S.

AU - Lempinen, Marko

AU - Smedby, Karin E.

N1 - Funding Information: This study was supported by the Strategic research program in epidemiology at Karolinska Institutet, and by ScandiaTransplant. Novartis provided funding for meetings and travel during the planning phase of the study. We thank ScandiaTransplant and the Renal Registries of respective country for access to data. The study has also used data from the Cancer Registries of Norway, Sweden, Denmark, and Finland. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway, Sweden, Denmark, or Finland is intended nor should be inferred. Publisher Copyright: © 2020 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020

Y1 - 2020

N2 - Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2–3.4). The AER of any cancer was 1560 cases (95% CI: 1468–1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778–901), non-Hodgkin lymphoma (145, 95% CI: 119–174), lung cancer (126, 95% CI: 98.2–149), and kidney cancer (122, 95% CI: 98.0–149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6–8.6%) and 16.8% (95% CI: 16.0–17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.

AB - Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2–3.4). The AER of any cancer was 1560 cases (95% CI: 1468–1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778–901), non-Hodgkin lymphoma (145, 95% CI: 119–174), lung cancer (126, 95% CI: 98.2–149), and kidney cancer (122, 95% CI: 98.0–149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6–8.6%) and 16.8% (95% CI: 16.0–17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.

KW - cancer

KW - incidence

KW - malignancy

KW - risk

KW - transplantation

U2 - 10.1111/tri.13734

DO - 10.1111/tri.13734

M3 - Article

C2 - 32896035

AN - SCOPUS:85091464460

SN - 0934-0874

VL - 33

SP - 1700

EP - 1710

JO - Transplant International

JF - Transplant International

IS - 12

ER -

Relative and absolute cancer risks among Nordic kidney transplant recipients—a population-based study

Abstract

Funding

UN SDGs

Keywords

Publication forum classification

ASJC Scopus subject areas

Access to Document

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