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Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals
Elizabeth L Yanik1, Christina A Clarke2, Jon J Snyder3
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; elizabeth.yanik@nih.gov.
Journal of the American Society of Nephrology : JASN
|November 14, 2015
Summary
Cancer risk in end-stage renal disease (ESRD) patients is influenced by kidney function and immunosuppression. Transplant recipients show higher risks for certain cancers, emphasizing ongoing screening and prevention needs.
Area of Science:
- Nephrology
- Oncology
- Immunology
Background:
- End-stage renal disease (ESRD) patients face altered cancer risks due to kidney dysfunction and post-transplant immunosuppression.
- Understanding cancer incidence patterns during dialysis and kidney transplantation is crucial for cancer etiology research.
Purpose of the Study:
- To evaluate cancer incidence in kidney transplant candidates and recipients across different kidney function states.
- To compare cancer risk during kidney function intervals (transplant) versus nonfunction intervals (waitlist/post-failure).
Main Methods:
- Utilized a linkage between the Scientific Registry of Transplant Recipients and cancer registries for 202,195 patients.
- Compared cancer incidence rates in kidney function intervals versus nonfunction intervals.
- Adjusted for demographic factors to isolate effects on cancer risk.
Main Results:
- Infection-related and immune-related cancers (Kaposi sarcoma, lymphomas, skin cancers) were significantly higher during kidney function intervals.
- ESRD-related cancers (kidney, thyroid) showed lower incidence during kidney function intervals.
- Cancer incidence patterns varied across intervals for several cancers, with many remaining elevated compared to the general population.
Conclusions:
- Kidney dysfunction and immunosuppression exert strong short-term effects on cancer incidence in ESRD patients.
- Persistent cancer screening and prevention strategies are essential for this population.
- The study highlights the dynamic interplay between kidney health, immunosuppression, and cancer development.
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