Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Internal Comparison
3.2. External Comparison
4. Discussion
4.1. Limitations
4.2. Future Directions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
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All Patients | ||
---|---|---|
N | % | |
Sex | ||
Male | 7286 | 63.8 |
Female | 4132 | 36.2 |
Age at transplant (years) | ||
18–39 | 2907 | 25.5 |
40–49 | 2682 | 23.5 |
50–59 | 3439 | 30.1 |
≥60 | 2390 | 20.9 |
Median (IQR) | 50 (39–58) | |
Calendar year at transplant | ||
1997–2004 | 5737 | 50.3 |
2005–2012 | 3893 | 34.1 |
2013–2021 | 1788 | 15.7 |
Area of residence | ||
Northern Italy | 6471 | 56.7 |
Central Italy | 1405 | 12.3 |
Southern Italy | 3489 | 30.5 |
Abroad | 53 | 0.5 |
Status of the donor | ||
Alive | 1079 | 9.4 |
Deceased | 10,339 | 90.6 |
Primary cause of kidney failure | ||
Glomerulonephritis | 4212 | 36.9 |
Polycystic kidney disease | 1936 | 17.0 |
Pyelonephritis/Interstitial nephritis | 1116 | 9.8 |
Hypertensive nephropathy/vascular disease | 691 | 6.0 |
Diabetes | 604 | 5.3 |
Congenital | 394 | 3.4 |
Uncertain | 1781 | 15.6 |
Other | 684 | 6.0 |
Follow-up (years) | ||
Median (IQR) | 7.1 (3.9–10.6) | |
Total person-years | 85,208.7 |
1997–2004 | 2005–2012 | 2013–2021 | 2005–2012 | 2013–2021 | 2005–2012 | 2013–2021 | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Cancer Site | No. | IR (SE) | No. | IR (SE) | No. | IR (SE) | Unadjusted IRR (95% CI) a | Ptrend | Adjusted IRR (95% CI) a,b | Ptrend | ||
All | 289 | 15.5 (0.9) | 771 | 19.9 (0.7) | 586 | 21.0 (0.9) | 1.29 (1.13–1.48) | 1.36 (1.18–1.57) | <0.01 | 1.05 (0.92-1.21) | 0.92 (0.80-1.06) | 0.11 |
All but NMSC | 194 | 10.4 (0.7) | 427 | 11.0 (0.5) | 310 | 11.1 (0.6) | 1.06 (0.90–1.26) | 1.07 (0.90–1.28) | 0.48 | 0.90 (0.76–1.07) | 0.72 (0.60–0.87) | <0.01 |
NMSC | 95 | 5.1 (0.5) | 344 | 8.9 (0.5) | 276 | 9.9 (0.6) | 1.75 (1.40–2.20) | 1.95 (1.54–2.46) | <0.01 | 1.36 (1.08–1.71) | 1.30 (1.02–1.65) | 0.11 |
Solid tumors | 114 | 6.1 (0.6) | 332 | 8.6 (0.5) | 257 | 9.2 (0.6) | 1.41 (1.14–1.74) | 1.51 (1.21–1.88) | <0.01 | 1.17 (0.95–1.46) | 1.00 (0.80–1.26) | 0.62 |
Kidney | 17 | 0.9 (0.2) | 46 | 1.2 (0.2) | 44 | 1.6 (0.2) | 1.31 (0.75–2.28) | 1.74 (0.99–3.04) | 0.04 | 1.30 (0.74–2.29) | 1.50 (0.84–2.67) | 0.17 |
Prostate | 13 | 0.7 (0.2) | 53 | 1.4 (0.2) | 33 | 1.2 (0.2) | 1.98 (1.08–3.63) | 1.71 (0.90–3.26) | 0.19 | 1.45 (0.78–2.67) | 0.97 (0.50–1.86) | 0.49 |
Bronchus and lung | 14 | 0.7 (0.2) | 44 | 1.1 (0.2) | 41 | 1.5 (0.2) | 1.52 (0.83–2.78) | 1.97 (1.07–3.61) | 0.03 | 1.14 (0.62–2.09) | 1.01 (0.55–1.89) | 0.88 |
Breast | 9 | 0.5 (0.2) | 33 | 0.9 (0.1) | 18 | 0.6 (0.2) | 1.78 (0.85–3.71) | 1.34 (0.60–2.99) | 0.65 | 1.62 (0.76–3.42) | 1.06 (0.46–2.41) | 0.81 |
Colon-rectum-anus | 7 | 0.4 (0.1) | 29 | 0.8 (0.1) | 23 | 0.8 (0.2) | 2.00 (0.88–4.57) | 2.21 (0.95–5.15) | 0.09 | 1.54 (0.67–3.54) | 1.39 (0.59–3.29) | 0.63 |
Bladder | 12 | 0.6 (0.2) | 30 | 0.8 (0.1) | 15 | 0.5 (0.1) | 1.21 (0.62–2.36) | 0.84 (0.39–1.80) | 0.58 | 0.97 (0.49–1.92) | 0.63 (0.29–1.37) | 0.20 |
Head and neck | 6 | 0.3 (0.1) | 19 | 0.5 (0.1) | 17 | 0.6 (0.1) | 1.53 (0.61–3.83) | 1.91 (0.75–4.84) | 0.17 | 1.29 (0.51–3.26) | 1.32 (0.51–3.43) | 0.62 |
Skin melanoma | 7 | 0.4 (0.1) | 13 | 0.3 (0.1) | 10 | 0.4 (0.1) | 0.90 (0.36–2.25) | 0.96 (0.37–2.52) | 0.96 | 0.92 (0.36–2.34) | 0.99 (0.36–2.70) | 0.99 |
Stomach | 5 | 0.3 (0.1) | 14 | 0.4 (0.1) | 8 | 0.3 (0.1) | 1.35 (0.49–3.76) | 1.07 (0.35–3.28) | 0.98 | 1.01 (0.36–2.84) | 0.49 (0.16–1.52) | 0.13 |
PTLD | 34 | 1.8 (0.3) | 52 | 1.3 (0.2) | 43 | 1.5 (0.2) | 0.74 (0.48–1.14) | 0.85 (0.54–1.33) | 0.56 | 0.69 (0.44–1.07) | 0.71 (0.44–1.13) | 0.19 |
NHL | 26 | 1.4 (0.3) | 39 | 1.0 (0.2) | 31 | 1.1 (0.2) | 0.73 (0.44–1.19) | 0.80 (0.48–1.35) | 0.47 | 0.69 (0.41–1.14) | 0.68 (0.39–1.17) | 0.19 |
Kaposi’s sarcoma | 46 | 2.5 (0.4) | 43 | 1.1 (0.2) | 10 | 0.4 (0.1) | 0.45 (0.30–0.69) | 0.15 (0.07–0.29) | <0.01 | 0.37 (0.24–0.57) | 0.09 (0.04–0.18) | <0.01 |
1997–2004 | 2005–2012 | 2013–2021 | Ptrend | ||
---|---|---|---|---|---|
Cancer Site | SIR (95% CI) | SIR (95% CI) | SIR (95% CI) | Unadjusted | Adjusted a |
All | 2.54 (2.26–2.85) | 2.38 (2.21–2.55) | 1.99 (1.83–2.16) | <0.01 | <0.01 |
All but NMSC | 1.96 (1.70–2.26) | 1.52 (1.38–1.67) | 1.23 (1.10–1.38) | <0.01 | <0.01 |
NMSC | 6.40 (5.18–7.83) | 8.05 (7.23–8.95) | 6.52 (5.77–7.33) | 0.40 | 0.42 |
Solid tumors | 1.27 (1.04–1.52) | 1.29 (1.16–1.44) | 1.12 (0.99–1.26) | 0.14 | 0.17 |
Kidney | 5.33 (3.10–8.53) | 5.17 (3.78–6.89) | 5.56 (4.04–7.46) | 0.81 | 0.38 |
Prostate | 1.28 (0.68–2.19) | 1.34 (1.00–1.75) | 0.85 (0.59–1.20) | 0.07 | 0.09 |
Bronchus and lung | 1.16 (0.64–1.95) | 1.33 (0.96–1.78) | 1.35 (0.97–1.83) | 0.68 | 0.86 |
Breast | 0.73 (0.33–1.38) | 1.08 (0.74–1.52) | 0.74 (0.44–1.17) | 0.78 | 0.71 |
Colon-rectum-anus | 0.61 (0.24–1.25) | 0.85 (0.57–1.22) | 0.73 (0.47–1.10) | 0.87 | 0.83 |
Bladder | 1.66 (0.86–2.90) | 1.38 (0.93–1.97) | 0.73 (0.41–1.21) | 0.02 | 0.12 |
Head and neck | 1.08 (0.40–2.36) | 1.49 (0.90–2.33) | 1.64 (0.96–2.63) | 0.40 | 0.45 |
Skin melanoma | 2.42 (0.97–5.00) | 1.66 (0.89–2.84) | 1.47 (0.70–2.70) | 0.34 | 0.58 |
Stomach | 1.34 (0.44–3.13) | 1.44 (0.79–2.42) | 0.90 (0.39–1.77) | 0.38 | 0.15 |
PTLD | 4.34 (3.01–6.07) | 2.51 (1.87–3.29) | 2.37 (1.72–3.20) | 0.02 | 0.11 |
NHL | 6.77 (4.42–9.92) | 3.96 (2.82–5.42) | 3.74 (2.54–5.31) | 0.04 | 0.17 |
Kaposi’s sarcoma | 189.16 (138.49–252.32) | 75.66 (54.76–101.92) | 20.19 (9.68–37.14) | <0.01 | <0.01 |
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Piselli, P.; Serraino, D.; Cimaglia, C.; Furian, L.; Biancone, L.; Busnach, G.; Bossini, N.; Todeschini, P.; Iaria, M.; Citterio, F.; et al. Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period. Cancers 2023, 15, 1347. https://doi.org/10.3390/cancers15041347
Piselli P, Serraino D, Cimaglia C, Furian L, Biancone L, Busnach G, Bossini N, Todeschini P, Iaria M, Citterio F, et al. Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period. Cancers. 2023; 15(4):1347. https://doi.org/10.3390/cancers15041347
Chicago/Turabian StylePiselli, Pierluca, Diego Serraino, Claudia Cimaglia, Lucrezia Furian, Luigi Biancone, Ghil Busnach, Nicola Bossini, Paola Todeschini, Maurizio Iaria, Franco Citterio, and et al. 2023. "Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period" Cancers 15, no. 4: 1347. https://doi.org/10.3390/cancers15041347