Buxeda Anna, Redondo-Pachón Dolores, Pérez-Sáez María José, Crespo Marta, Pascual Julio
Department of Nephrology, Hospital del Mar, Barcelona, Spain.
Department of Nephrology, Hospital del Mar, Barcelona, Spain.
Transplant Rev (Orlando). 2021 Jul;35(3):100625. doi: 10.1016/j.trre.2021.100625. Epub 2021 May 1.
Kidney transplant recipients (KTRs) experience a two- to four-fold increased risk of developing and dying from cancer compared with the general population. High cancer risk results from the interaction of both modifiable and non-modifiable factors. This mapping review explores the impact of sex disparity on cancer's increased incidence and mortality after kidney transplantation (KT). In terms of age, population-based studies indicate that younger recipients of both sexes experience a higher risk of cancer, but this is more pronounced in young women. On the contrary, older men are more likely to be diagnosed with cancer, although their increased risk is not statistically significant compared with the general population. Regarding cancer type, studies show an increased risk of Kaposi sarcoma, gynecologic and lung cancer in women, and bladder and kidney cancer in men. Immune-related cancers such as pos-transplant lymphoproliferative disorders and melanoma are increased in both sexes. Mortality also shows differences between sexes. Although cancer is the second cause of death in both male and female KTRs, studies show higher overall mortality in men and elderly recipients. However, the relative risk of cancer mortality compared with the general population is higher at a younger age, with disparate results regarding sex. Female KTRs appear to die at a younger age than males when compared with the general population. Differences in cancer rates by sex after renal transplantation need further studies. A better understanding of sex-specific differences in cancer epidemiology after KT could help nephrologists to better address pre-transplant counseling, to establish early surveillance programs, and to plan modifiable risk factors such as immunosuppression.
与普通人群相比，肾移植受者（KTRs）患癌症及因癌症死亡的风险增加了两到四倍。高癌症风险是由可改变和不可改变因素相互作用导致的。本映射综述探讨了性别差异对肾移植（KT）后癌症发病率和死亡率增加的影响。在年龄方面，基于人群的研究表明，两性中较年轻的受者患癌症的风险更高，但在年轻女性中更为明显。相反，老年男性更有可能被诊断出患有癌症，尽管与普通人群相比，他们增加的风险在统计学上并不显著。关于癌症类型，研究表明女性患卡波西肉瘤、妇科癌症和肺癌的风险增加，男性患膀胱癌和肾癌的风险增加。两性中与免疫相关的癌症如移植后淋巴细胞增生性疾病和黑色素瘤都有所增加。死亡率在性别之间也存在差异。尽管癌症是男性和女性肾移植受者的第二大死因，但研究表明男性和老年受者的总体死亡率更高。然而，与普通人群相比，癌症死亡率的相对风险在年轻时更高，性别结果存在差异。与普通人群相比，女性肾移植受者似乎比男性死亡年龄更小。肾移植后癌症发病率的性别差异需要进一步研究。更好地了解肾移植后癌症流行病学中的性别特异性差异，有助于肾病学家更好地进行移植前咨询、建立早期监测计划，并规划可改变的风险因素，如免疫抑制。
