Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Cancer is the second leading cause of post-transplant mortality. Since racial disparities have been reported in many aspects of transplant care, we sought to determine wether these disparities extend to post-transplant cancer mortality.
*Methods: Using data from USRDS and SRTR, we studied adult, Medicare primary kidney transplant recipients from 1999 through 2014. We studied the 6 most common cancers following kidney transplantation (non-Hodgkin’s lymphoma, lung, breast, prostate, kidney, and colorectal), which were identified using validated ICD-9 codes. We used multivariable Cox regression, treating cancer as a time-varying exposure, to determine the association between race and post-transplant cancer mortality.
*Results: Among 120,031 kidney transplant recipients, 15,375 (12.5%) developed post-transplant cancer. The most frequently diagnosed cancers were non-Hodgkin’s lymphoma (31.3%) and kidney cancer (24.5%). Of those with a post-transplant cancer, 33.0% underwent surgery, 5.8% underwent radiation, 2.1% underwent chemotherapy 2.1% underwent chemotherapy, and 10.1% underwent combined treatment. Overall, recipients with a post-transplant cancer had a 3.82-fold increased risk of mortality compared to those who did not develop cancer (adjusted Hazard Ratio (aHR):3.673.823.98,p<0.001); however this relationship varied by race (Table 1). White recipients who developed cancer (aHR:4.224.454.69, p<0.001) had a higher adjusted hazard ratio for mortality than all other racial groups: Black/African American (aHR:2.712.903.11, p for interaction<0.001), and Hispanic (aHR:3.133.503.92, p for interaction<0.001).
*Conclusions: Despite the typically worse outcomes for Black/African American transplant recipients, in our study we found worse outcomes among Caucasians. Additional work is necessary to identify causes of these differences and how best to mitigate them.
To cite this abstract in AMA style:Cordrey K, Motter J, Kernodle A, Jackson K, Camp M, Purnell T, Segev D, Wang JGaronzik. Racial Differences in Cancer Mortality for Kidney Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/racial-differences-in-cancer-mortality-for-kidney-transplant-recipients/. Accessed May 9, 2021.
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