Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy.
Int J Cancer. 2024 Mar 1;154(5):842-851. doi: 10.1002/ijc.34787. Epub 2023 Nov 4.
Kidney transplant (KT) recipients are known to be at risk of developing several cancer types; however, cancer mortality in this population is underinvestigated. Our study aimed to assess the risk of cancer death among Italian KT recipients compared to the corresponding general population. A cohort study was conducted among 7373 individuals who underwent KT between 2003 and 2020 in 17 Italian centers. Date and cause of death were retrieved until 31 December 2020. Indirect standardization was used to estimate standardized mortality ratios (SMRs) and corresponding 95% confidence intervals (CIs). Cancer was the most common cause of death among the 7373 KT recipients, constituting 32.4% of all deaths. A 1.8-fold excess mortality (95% CI: 1.59-2.09) was observed for all cancers combined. Lymphomas (SMR = 6.17, 95% CI: 3.81-9.25), kidney cancer (SMR = 5.44, 95% CI: 2.97-8.88) and skin melanoma (SMR = 3.19, 95% CI: 1.03-6.98) showed the highest excess death risks. In addition, SMRs were increased about 1.6 to 3.0 times for cancers of lung, breast, bladder and other hematopoietic and lymphoid tissues. As compared to the general population, relative cancer mortality risk remained significantly elevated in all age groups though it decreased with increasing age. A linear temporal increase in SMR over time was documented for all cancers combined (P < .01). Our study documented significantly higher risks of cancer death in KT recipients than in the corresponding general population. Such results support further investigation into the prevention and early detection of cancer in KT recipients.
肾移植（KT）受者已知存在多种癌症类型的风险；然而，该人群的癌症死亡率尚未得到充分研究。我们的研究旨在评估与普通人群相比，意大利 KT 受者的癌症死亡风险。在 17 个意大利中心进行了一项队列研究，纳入了 7373 名在 2003 年至 2020 年间接受 KT 的个体。截至 2020 年 12 月 31 日，检索了死亡日期和原因。使用间接标准化来估计标准化死亡率比（SMR）和相应的 95%置信区间（CI）。在 7373 名 KT 受者中，癌症是最常见的死亡原因，占所有死亡人数的 32.4%。观察到所有癌症的死亡率增加了 1.8 倍（95%CI：1.59-2.09）。淋巴瘤（SMR=6.17，95%CI：3.81-9.25）、肾细胞癌（SMR=5.44，95%CI：2.97-8.88）和皮肤黑色素瘤（SMR=3.19，95%CI：1.03-6.98）的超额死亡风险最高。此外，肺癌、乳腺癌、膀胱癌和其他造血和淋巴组织的癌症的 SMR 增加了 1.6 到 3.0 倍。与普通人群相比，所有年龄组的相对癌症死亡率风险仍然显著升高，但随着年龄的增长而降低。所有癌症的 SMR 随时间呈线性增加（P<0.01）。我们的研究记录了 KT 受者的癌症死亡风险明显高于普通人群。这些结果支持进一步研究 KT 受者的癌症预防和早期发现。
