Decreasing incidence of cancer after liver transplantation-A Nordic population-based study over 3 decades.
Cancer remains one of the most serious long-term complications after liver transplantation (LT). Data for all adult LT patients between 1982 and 2013 were extracted from the Nordic Liver Transplant Registry. Through linkage with respective national cancer-registry data, we calculated standardized incidence ratios (SIRs) based on country, sex, calendar time, and age-specific incidence rates. Altogether 461 cancers were observed in 424 individuals of the 4246 LT patients during a mean 6.6-year follow-up. The overall SIR was 2.22 (95% confidence interval [CI], 2.02-2.43). SIRs were especially increased for colorectal cancer in recipients with primary sclerosing cholangitis (4.04) and for lung cancer in recipients with alcoholic liver disease (4.96). A decrease in the SIR for cancers occurring within 10 years post-LT was observed from the 1980s: 4.53 (95%CI, 2.47-7.60), the 1990s: 3.17 (95%CI, 2.70-3.71), to the 2000s: 1.76 (95%CI, 1.51-2.05). This was observed across age- and indication-groups. The sequential decrease for the SIR of non-Hodgkin lymphoma was 25.0-12.9-7.53, and for nonmelanoma skin cancer 80.0-29.7-10.4. Cancer risk after LT was found to be decreasing over time, especially for those cancers that are strongly associated with immunosuppression. Whether immunosuppression minimization contributed to this decrease merits further study.
['Nordin|A|A|0000-0002-5446-0972', 'Åberg|F|F|', 'Pukkala|E|E|', 'Pedersen|C R|CR|', 'Storm|H H|HH|', 'Rasmussen|A|A|', 'Bennet|W|W|', 'Olausson|M|M|', 'Wilczek|H|H|', 'Ericzon|B-G|BG|', 'Tretli|S|S|', 'Line|P-D|PD|', 'Karlsen|T H|TH|', 'Boberg|K M|KM|', 'Isoniemi|H|H|']
D000328:Adult D015331:Cohort Studies D015179:Colorectal Neoplasms D005260:Female D005500:Follow-Up Studies D006801:Humans D015994:Incidence D008113:Liver Neoplasms D016031:Liver Transplantation D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D011379:Prognosis D012042:Registries D012307:Risk Factors D012537:Scandinavian and Nordic Countries
cancer/malignancy/neoplasia: registry/incidence cancer/malignancy/neoplasia: risk factors clinical research/practice liver transplantation/hepatology