Risk of Thyroid Cancer Among Solid Organ Transplant Recipients

Solid organ transplant recipients have an elevated incidence of thyroid cancer. We evaluated a wide range of potential risk factors in a cohort of 229 300 U.S. solid organ transplant recipients linked with 15 stage/regional cancer registries (1987–2012). Incidence rate ratios (IRRs) were adjusted fo...

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Bibliographic Details
Published in:American journal of transplantation 2017-11, Vol.17 (11), p.2911-2921
Main Authors: Kitahara, C. M., Yanik, E. L., Ladenson, P. W., Hernandez, B. Y., Lynch, C. F., Pawlish, K. S., Engels, E. A.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
cancer/malignancy/neoplasia: risk factors
Cirrhosis
clinical research/practice
Dialysis
epidemiology
Ethnicity
Female
Follow-Up Studies
Graft rejection
Grafts
Health risk assessment
Hemodialysis
Humans
immunosuppression/immune modulation
Incidence
Kidney transplantation
kidney transplantation/nephrology
Liver
Liver cirrhosis
Liver diseases
Liver transplantation
Male
Middle Aged
Minority & ethnic groups
Organ Transplantation - adverse effects
organ transplantation in general
Prognosis
Registries
Renal Dialysis - statistics & numerical data
Risk Factors
Thyroid cancer
Thyroid Neoplasms - epidemiology
Thyroid Neoplasms - etiology
translational research/science
Transplant Recipients
Transplantation
Transplants & implants
United States - epidemiology
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Summary:Solid organ transplant recipients have an elevated incidence of thyroid cancer. We evaluated a wide range of potential risk factors in a cohort of 229 300 U.S. solid organ transplant recipients linked with 15 stage/regional cancer registries (1987–2012). Incidence rate ratios (IRRs) were adjusted for age, sex, race/ethnicity, transplanted organ, year of transplantation, and time since transplantation. Hazard ratios (HRs) for death and/or graft failure were adjusted for age, sex, race/ethnicity, transplanted organ, and year of transplantation. After transplantation, 356 thyroid cancers were diagnosed. Thyroid cancer incidence was 2.50‐fold higher in transplant recipients than the general population (95% confidence interval [CI] 2.25–2.77). Among recipients of different organs, kidney recipients had the highest incidence of thyroid cancer (IRR = 1.26, 95% CI 1.03–1.53). Elevated thyroid cancer incidence was associated with cholestatic liver disease/cirrhosis as an indication for liver transplantation (IRR = 1.69, 95% CI 1.09–2.63), hypertensive nephrosclerosis as an indication for kidney transplantation (IRR = 1.41, 95% CI 1.03–1.94), and longer prior dialysis among kidney recipients (5+ vs.
ISSN:1600-6135
1600-6143
1600-6143
DOI:10.1111/ajt.14310