Patients who are diagnosed with cancer following solid organ transplantation have reduced survival, a new study confirms. The life years lost varied by cancer type.
Among 221,962 US transplant recipients, new cancers developed in 13,074 (5.9%) of them within 10 years of transplantation. During 1987-2014, the mean life years lost (LYL) due to cancer were 0.16 years per transplant recipient and 2.7 years per cancer case within the 10-year period after transplant surgery, Anne-Michelle Noone, PhD, MS, of the National Cancer Institute in Bethesda, Maryland, and colleagues reported in Cancer. Cancer reduced by 1.9% the total life-years expected in transplant recipients.
Total LYL due to cancer increased with age, from 0.5% among patients aged less than 1 year to 34 years at the time of organ transplantation to 3.2% among patients aged 50 years and older.
Lung cancer was the largest contributor to premature death, accounting for 24% of all LYL due to cancer, followed by non-Hodgkin lymphoma (15%).
By transplanted organ, lung, heart, liver, and kidney recipients lost 0.27, 0.23, 0.18, and 0.14 life-years due to cancer per recipient, respectively. Male recipients lost slightly more life-years than female recipients: 0.18 vs 0.12 LYL per recipient.
Solid organ transplant recipients have excess cancer risks compared with the general population due to immunosuppression, comorbidities, and end-stage organ disease.
“There are opportunities to reduce cancer mortality and extend the lives of transplant recipients through prevention and screening,” Dr Noone’s team concluded. “Because large proportions of LYL are caused [by non-Hodgkin lymphoma] and lung cancer, these cancers should be a priority.”
High levels of circulating Epstein-Barr virus load can be used as a marker of posttransplant lymphoproliferative disorder risk, especially in pediatric recipients, the investigators suggested. Older adults should receive smoking cessation interventions and lung imaging.
Noone A-M, Pfeiffer RM, Schaubel DE, et al. Life-years lost due to cancer among solid organ transplant recipients in the United States, 1987 to 2014. Cancer. Published online September 20, 2021. doi:10.1002/cncr.33877