Cancer risk in living kidney donors. Issue 8 (24th May 2022)

• Record Type: Journal Article
• Authors: Engels, Eric A.; Fraser, Gary E.; Kasiske, Bertram L.; Snyder, Jon J.; Utt, Jason; Lynch, Charles F.; Li, Jie; Pawlish, Karen S.; Brown, Sandra; Yu, Kelly J.; Pfeiffer, Ruth M.
• Is Part Of: American journal of transplantation. Volume 22:Issue 8(2022)
• Page Start: 2006
• Page End: 2015
• Publication Date: 2022-05-24
• Subjects: cancer screening -- chronic kidney disease -- colorectal cancer -- kidney cancer -- kidney donation -- kidney transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.17082
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract: Living kidney donors are screened for transmissible diseases including cancer. Outcomes following donation are excellent, but concern exists regarding development of chronic kidney disease, and cancer risk is unknown. We used linked transplant and cancer registry data to identify incident cancers among 84, 357 kidney donors in the United States (1995–2017). We compared risk with the general population using standardized incidence ratios (SIRs). For selected cancers, we used Poisson regression to compare donors with 47, 451 Adventist Health Study 2 (AHS‐2) participants, who typically have healthy lifestyles. During follow‐up, 2843 cancers were diagnosed in donors, representing an overall deficit (SIR 0.79, 95%CI 0.76–0.82). None of 46 specified cancer sites occurred in excess relative to the general population, and 15 showed significant deficits (SIR < 1.00). Compared with AHS‐2 participants, donors had similar incidence of liver cancer, melanoma, breast cancer, and non‐Hodgkin lymphoma but, starting 7 years after donation, elevated incidence of colorectal cancer (adjusted incidence rate ratio 2.07, 95%CI 1.54–2.79) and kidney cancer (2.97, 1.58–5.58, accounting for the presence of a single kidney in donors). Elevated kidney cancer incidence may reflect adverse processes in donors' remaining kidney. Nonetheless, cancer risk is lower than in the general population, suggesting that enhanced screening is unnecessary. Abstract : This registry‐based study demonstrates that live kidney donors in the United States have an elevated risk of subsequent kidney cancer which, though small in absolute magnitude, may reflect adverse processes in the donors' remaining kidney. Sharif comment on (page 1941 )