Kim Hyunho, Chae Kyung-Hee, Choi Arum, Kim Mi-Hyeong, Hong Ji Hyung, Choi Bum Soon, Kim Sukil, Ban Tae Hyun
Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Int Urol Nephrol. 2025 Mar;57(3):715-722. doi: 10.1007/s11255-024-04244-w. Epub 2024 Oct 23.
To investigate the risk of genitourinary (GU) cancer in kidney transplant recipients (KTRs) compared to that in the general population, focusing on potential risk factors and clinical implications.
Using a national cohort of approximately 360,000 individuals, including 31,542 KTRs, we conducted a retrospective analysis of the data from 2007 to 2018. Propensity score matching was used to compare KTRs with a healthy population, adjusting for age, sex, diabetes, hypertension, and hypercholesterolemia.
We identified a significantly increased risk of GU cancers, particularly bladder and kidney cancers, in KTRs. Multivariate analysis revealed a higher risk of GU cancer associated with kidney transplantation [hazard ratio (HR) 2.133, 95% confidence interval (CI) 1.641-2.772] and hypercholesterolemia (HR 1.725, 95% CI 1.227-2.425), with older age and male sex also being significant risk factors. Conversely, no significant increase in prostate cancer risk was observed in KTRs compared to the general population.
This national cohort-based study indicated an increased risk of GU cancer in KTRs, underscoring the need for targeted cancer surveillance and pre- and post-transplant counseling. These findings provide valuable insights for the development of cancer surveillance programs for KTRs and highlight the necessity for further research in this field.
调查肾移植受者（KTRs）与普通人群相比发生泌尿生殖系统（GU）癌症的风险，重点关注潜在风险因素及临床意义。
利用一个约360,000人的全国队列，其中包括31,542名KTRs，我们对2007年至2018年的数据进行了回顾性分析。采用倾向评分匹配法将KTRs与健康人群进行比较，并对年龄、性别、糖尿病、高血压和高胆固醇血症进行了调整。
我们发现KTRs发生GU癌症的风险显著增加，尤其是膀胱癌和肾癌。多因素分析显示，肾移植（风险比[HR] 2.133，95%置信区间[CI] 1.641 - 2.772）和高胆固醇血症（HR 1.725，95% CI 1.227 - 2.425）与GU癌症风险较高相关，年龄较大和男性也是显著的风险因素。相反，与普通人群相比，未观察到KTRs患前列腺癌的风险有显著增加。
这项基于全国队列的研究表明KTRs发生GU癌症的风险增加，强调了进行针对性癌症监测以及移植前后咨询的必要性。这些发现为制定KTRs癌症监测项目提供了有价值的见解，并突出了该领域进一步研究的必要性。
