Cancer Mortality Among Recipients of Solid Organ Transplant in Ontario
1Institute of Health Policy, Management and Education, University of Toronto, Toronto, ON, Canada
2Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada
3Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: D227
Keywords: Malignancy, Mortality, Post-transplant malignancy, Survival
Session Information
Date: Tuesday, May 5, 2015
Session Name: Poster Session D: PTLD/Malignancies: All Topics
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Purpose: Solid organ transplantation recipients (SOTR) have a higher risk of some cancers than the general population, but are also at high risk of mortality from non-cancer causes. Thus, the impact of transplantation on cancer morality is unclear. This study aimed to describe cancer mortality in a population-based cohort of SOTR.
Patients and Methods: All SOTR transplanted between 1991 and 2010 in the province of Ontario were identified from the provincial transplant register and these data were linked to the Ontario Cancer Registry and administrative health data. Cancer mortality for SOTRs was compared to the general population using standardized mortality rates (SMR).
Results: We identified 11,061 SOTR: 6,516 kidney, 2,606 liver, 929 heart, and 705 lung transplant recipients. Of these 603 (19.7%) died of cancer. Cancer mortality risk in SOTR was significantly elevated compared to the Ontario population (SMR=2.84, 95% CI: 2.61–3.07). The risk remained elevated when patients with pre-transplant malignancies (n=1,124) were excluded (SMR=1.85; 95% CI: 1.67-2.04). The increased risk was observed irrespective of transplanted organ and sex. The SMR for cancer death after SOTR was higher in children and lower in patients >60 years, but remained elevated compared to the general population at any age of transplantation.
Conclusion: Risk of cancer death in SOTRs was increased compared to the general population, reflecting significant burden of cancer mortality despite competing risks for death. Rigorous clinical surveillance and a better understanding of cancer treatment in SOTRs are needed to reduce the burden of cancer mortality in this population.
To cite this abstract in AMA style:
Acuna S, Fernandes K, Daly C, Hicks L, Sutradhar R, Kim S, Baxter1 N. Cancer Mortality Among Recipients of Solid Organ Transplant in Ontario [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/cancer-mortality-among-recipients-of-solid-organ-transplant-in-ontario/. Accessed February 27, 2020.« Back to 2015 American Transplant Congress