Hind Harrak, MS, of Maisonneuve-Rosemont Hospital Research Center in Montreal, and colleagues studied 4,574 patients starting chronic dialysis from January 1, 2001 to December 31, 2007 in Quebec. The researchers excluded patients with a prior cancer diagnosis. Exposure to ESAs was evaluated from 6-9 months prior to the first cancer diagnosis. Mean exposure to ESAs was categorized as low dose (less than 30 μg/week), moderate dose (30-70 μg per week), and high dose (more than 70 μg per week).
The investigators identified 319 cases of cancer and 3,895 matched controls during the study period. Compared with patients not exposed to ESAs, patients in the high-dose group had a 77% increased risk of a cancer diagnosis.