1987年至2018年期间,美国实体器官移植患者的癌症死亡率
Jeanny H Wang1, Ruth M Pfeiffer1, Donnie Musgrove2
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
Transplantation
|June 9, 2023
概括
固体器官移植接受者面临的癌症死亡率高于普通人群. 移植后针对肺,皮肤和非霍奇金淋巴瘤 (NHL) 的查,以及管理先前存在的肝癌,可以提高生存率.
科学领域:
- 在瘤学瘤学.
- 移植医学 移植医学
- 流行病学 流行病学
背景情况:
- 固体器官移植接受者 (接受者) 患癌症的风险增加,诊断后的生存率降低.
- 评估接受者的癌症死亡率对于改善移植前和移植后癌症的结果至关重要.
研究的目的:
- 评估实体器官移植接受者癌症死亡率模式和风险因素.
- 为了将接受者的癌症死亡率与一般人口进行比较.
主要方法:
- 将美国移植注册数据与国家死亡指数联系起来,在671,127名接受者 (1987-2018) 中,有126,474例死亡.
- 采用波桑回归来确定癌症死亡风险因素.
- 计算标准化死亡率 (SMRs) 以将接受者癌症死亡率与一般人口进行比较,根据移植前或移植后的癌症诊断对死亡进行分类.
主要成果:
- 癌症导致13%的死亡;肺癌,肝癌和非霍奇金淋巴瘤 (NHL) 是最常见的.
- 总体癌症死亡率升高 (SMR 2.33),非黑色素瘤皮肤癌 (23.4),NHL (5.17),癌 (3.40),黑色素瘤 (3.27) 和肝癌在肝接受者 (26.0) 中显著增加.
- 大多数癌症死亡 (93.3%) 与移植后的诊断有关,肝脏接受者肝脏癌症除外.
结论:
- 建议加强移植后查和预防肺癌,NHL和皮肤癌的预防策略.
- 改善先前患有肝癌的肝接受者管理可能会降低死亡率.
- 这些干预措施对于改善移植受体癌症存活率至关重要.
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