Post-transplant malignancies in minority populations

Post-transplant malignancy (PTM), is emerging as an important cause of early morbidity and mortality following transplantation (TX). Unfortunately its prevalence in minorities (African-Americans, AA; Native Americans, NA; Asian Pacific Islanders, AP; American Indians, AI; Latino-Hispanics, LH) in the United States, though important, remains unknown. Published reports of prevalence rates by different centers, including the Cincinnati Transplant Tumor Registry (CITTR) of about 4%-18% though informative, remain of little help. These reports erroneously assume a homogeneity in population, uniformity in the impact and spread of the determinants of this disease, and equal access to health for all patients. Data from AA, the only minority group studied by the Howard University Hospital Transplant Center (HUHTC) group, in Washington, D.C.; revealed a cancer occurrence of 3% in 339 TX patients. It is important to note that unlike the CITTR data base, the HUHTC cancer database is smaller. Nevertheless, a comparative analysis was revealing. Skin/lymphoid cancers had a lower occurrence (20% versus 54%), while head and neck tumors had a higher occurrence (30% versus 3%) as were genitourinary cancers (30% versus 8%) in AA as compared to the general population. Since minorities as a group are prone to higher cancer prevalence and mortality rates, and because patterns of PTM may differ among groups, studies to analyze PTM and other factors that may further escalate cancer rates in minorities deserve greater impetus.