Malignancy in uremia: dialysis versus transplantation

The incidence of cancer was compared in 499 dialysis patients and 121 renal transplant recipients. De novo malignancy developed in 15 patients on chronic dialysis (3 per cent) and in 6 transplant recipients (4.9 per cent), a significant increase over the expected number in the age-matched general population. There was no difference in the incidence of cancer in uremic patients on dialysis or after transplantation. A total of 10 dialysis patients (67 per cent) and 1 transplant patient (16 per cent) died of cancer. Neoplasms in the dialysis patients were the common types of mesenchymal tumors, while superficial skin cancers were seen more frequently in the transplant recipients. The differences in tumor types accounted for the higher mortality rate from cancer in the dialysis patients and may reflect different patterns of immunosuppression in these 2 patient populations.