Cancer Incidence among Heart, Kidney, and Liver Transplant Recipients in Taiwan

PLoS One. 2016 May 19;11(5):e0155602. doi: 10.1371/journal.pone.0155602. eCollection 2016.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cohort Studies
  • Databases, Factual
  • Female
  • Heart Failure / complications
  • Heart Failure / surgery
  • Heart Transplantation*
  • Humans
  • Incidence*
  • Infant
  • Infant, Newborn
  • Kidney Transplantation*
  • Liver Failure / complications
  • Liver Failure / surgery
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology*
  • Proportional Hazards Models
  • Renal Insufficiency / complications
  • Renal Insufficiency / surgery
  • Risk
  • Taiwan
  • Young Adult

Grants and funding

This work was funded by National Science Council (MOST 103-2314-B-016 -022 -MY3) and partially by Tri-service General Hospital (TSGH-C103-028-013, TSGH-C104-031 and TSGH-C105-007-S01), Taiwan. This study is based in part on data from the National Health Insurance Research Database provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by National Health Research Institutes (Registered number NHIRD-103-164). The interpretation and conclusions contained herein do not represent those of National Health Insurance Administration, Ministry of Health and Welfare or National Health Research Institutes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.