Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy

Martina Taborelli, Federica Toffolutti, Stefania Del Zotto, Elena Clagnan, Lucrezia Furian, Pierluca Piselli, Franco Citterio, Loris Zanier, Giuliano Boscutti, Diego Serraino, Sarah Shalaby, Raffaella Petrara, Patrizia Burra, Giacomo Zanus, Stefano Zanini, Paolo Rigotti, Maria Rendina, Alfredo Di Leo, Francesco Paolo Schena, Giuseppe GrandalianoMarco Fiorentino, Augusto Lauro, Antonio Daniele Pinna, Paolo Di Gioia, Sara Pellegrini, Chiara Zanfi, Maria Piera Scolari, Sergio Stefoni, Paola Todeschini, Laura Panicali, Chiara Valentini, Umberto Baccarani, Andrea Risaliti, Gian Luigi Adani, Dario Lorenzin, Giuseppe Maria Ettorre, Giovanni Vennarecci, Marco Colasanti, Manuela Coco, Fabrizio Ettorre, Roberto Santoro, Lucia Miglioresi, Francesco Nudo, Massimo Rossi, Gianluca Mennini, Luca Toti, Giuseppe Tisone, Annachiara Casella, Laura Fazzolari, Daniele Sforza, Giuseppe Iaria, Carlo Gazia, Chiara Belardi, Claudia Cimaglia, Alessandro Agresta, Gianpiero D'Offizi, Ubaldo Visco Comandini, Raffaella Lionetti, Marzia Montalbano, Chiara Taibi, Giovanni Fantola, Fausto Zamboni, Gian Benedetto Piredda, Maria Benigna Michittu, Maria Gavina Murgia, Bruno Onano, Lucia Fratino, Luigino Dal Maso, Paolo De Paoli, Diana Verdirosi, Emanuela Vaccher, Francesco Pisani, Antonio Famulari, Federica Delreno, Samuele Iesari, Linda De Luca, Maurizio Iaria, Enzo Capocasale, Elena Cremaschi, Silvio Sandrini, Francesca Valerio, Valentina Mazzucotelli, Nicola Bossini, Gisella Setti, Massimiliano Veroux, Pierfrancesco Veroux, Alessia Giaquinta, Domenico Zerbo, Ghil Busnach, Laura Di Leo, Maria Luisa Perrino, Marialuisa Querques, Valeriana Colombo, Maria Chiara Sghirlanzoni, Piergiorgio Messa, Antonio Leoni, Laura Galatioto, Salvatore Gruttadauria, Vito Sparacino, Flavia Caputo, Barbara Buscemi, Gionata Spagnoletti, Maria Paola Salerno, Evaldo Favi, Giuseppe Paolo Segoloni, Luigi Biancone, Antonio Lavacca, Maria Cristina Maresca, Carmelo Cascone, Bice Virgilio, Donato Donati, Fiorella Dossi, Andrea Fontanella, Andrea Ambrosini, Marco Di Cicco

Research output: Contribution to journalArticle

Abstract

Background: In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy. Methods: A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998-2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). Results: During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15-1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42-2.45 for age 40-59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89-10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06-4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46-2.22), oral cavity (SIR = 2.42, 95% CI: 1.36-4.00), and Kaposi's sarcoma (SIR = 10.29, 95% CI: 1.25-37.16). Conclusions: The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.

Original languageEnglish
Article number107
Pages (from-to)1-8
Number of pages8
JournalBMC Nephrology
Volume20
Issue number1
DOIs
Publication statusPublished - Mar 28 2019

Keywords

  • Cancer risk
  • de novo malignancies
  • Dialysis
  • End-stage kidney disease
  • Italy
  • Population-based study

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Taborelli, M., Toffolutti, F., Del Zotto, S., Clagnan, E., Furian, L., Piselli, P., Citterio, F., Zanier, L., Boscutti, G., Serraino, D., Shalaby, S., Petrara, R., Burra, P., Zanus, G., Zanini, S., Rigotti, P., Rendina, M., Di Leo, A., Schena, F. P., ... Di Cicco, M. (2019). Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy. BMC Nephrology, 20(1), 1-8. [107]. https://doi.org/10.1186/s12882-019-1283-4