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

1 Citation (Scopus)

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

Fingerprint

Italy
Dialysis
Cohort Studies
Confidence Intervals
Population
Neoplasms
Incidence
Kidney
Kaposi's Sarcoma
Chronic Kidney Failure
Registries
Mouth
Databases
Delivery of Health Care
Transplants
Skin

Keywords

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

ASJC Scopus subject areas

  • Nephrology

Cite this

Taborelli, M., Toffolutti, F., Del Zotto, S., Clagnan, E., Furian, L., Piselli, 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

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

In: BMC Nephrology, Vol. 20, No. 1, 107, 28.03.2019, p. 1-8.

Research output: Contribution to journalArticle

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, FP, Grandaliano, G, Fiorentino, M, Lauro, A, Pinna, AD, Di Gioia, P, Pellegrini, S, Zanfi, C, Scolari, MP, Stefoni, S, Todeschini, P, Panicali, L, Valentini, C, Baccarani, U, Risaliti, A, Adani, GL, Lorenzin, D, Ettorre, GM, Vennarecci, G, Colasanti, M, Coco, M, Ettorre, F, Santoro, R, Miglioresi, L, Nudo, F, Rossi, M, Mennini, G, Toti, L, Tisone, G, Casella, A, Fazzolari, L, Sforza, D, Iaria, G, Gazia, C, Belardi, C, Cimaglia, C, Agresta, A, D'Offizi, G, Comandini, UV, Lionetti, R, Montalbano, M, Taibi, C, Fantola, G, Zamboni, F, Piredda, GB, Michittu, MB, Murgia, MG, Onano, B, Fratino, L, Maso, LD, De Paoli, P, Verdirosi, D, Vaccher, E, Pisani, F, Famulari, A, Delreno, F, Iesari, S, De Luca, L, Iaria, M, Capocasale, E, Cremaschi, E, Sandrini, S, Valerio, F, Mazzucotelli, V, Bossini, N, Setti, G, Veroux, M, Veroux, P, Giaquinta, A, Zerbo, D, Busnach, G, Di Leo, L, Perrino, ML, Querques, M, Colombo, V, Sghirlanzoni, MC, Messa, P, Leoni, A, Galatioto, L, Gruttadauria, S, Sparacino, V, Caputo, F, Buscemi, B, Spagnoletti, G, Salerno, MP, Favi, E, Segoloni, GP, Biancone, L, Lavacca, A, Maresca, MC, Cascone, C, Virgilio, B, Donati, D, Dossi, F, Fontanella, A, Ambrosini, A & Di Cicco, M 2019, 'Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy', BMC Nephrology, vol. 20, no. 1, 107, pp. 1-8. https://doi.org/10.1186/s12882-019-1283-4
Taborelli, Martina ; Toffolutti, Federica ; Del Zotto, Stefania ; Clagnan, Elena ; Furian, Lucrezia ; Piselli, Pierluca ; Citterio, Franco ; Zanier, Loris ; Boscutti, Giuliano ; Serraino, Diego ; Shalaby, Sarah ; Petrara, Raffaella ; Burra, Patrizia ; Zanus, Giacomo ; Zanini, Stefano ; Rigotti, Paolo ; Rendina, Maria ; Di Leo, Alfredo ; Schena, Francesco Paolo ; Grandaliano, Giuseppe ; Fiorentino, Marco ; Lauro, Augusto ; Pinna, Antonio Daniele ; Di Gioia, Paolo ; Pellegrini, Sara ; Zanfi, Chiara ; Scolari, Maria Piera ; Stefoni, Sergio ; Todeschini, Paola ; Panicali, Laura ; Valentini, Chiara ; Baccarani, Umberto ; Risaliti, Andrea ; Adani, Gian Luigi ; Lorenzin, Dario ; Ettorre, Giuseppe Maria ; Vennarecci, Giovanni ; Colasanti, Marco ; Coco, Manuela ; Ettorre, Fabrizio ; Santoro, Roberto ; Miglioresi, Lucia ; Nudo, Francesco ; Rossi, Massimo ; Mennini, Gianluca ; Toti, Luca ; Tisone, Giuseppe ; Casella, Annachiara ; Fazzolari, Laura ; Sforza, Daniele ; Iaria, Giuseppe ; Gazia, Carlo ; Belardi, Chiara ; Cimaglia, Claudia ; Agresta, Alessandro ; D'Offizi, Gianpiero ; Comandini, Ubaldo Visco ; Lionetti, Raffaella ; Montalbano, Marzia ; Taibi, Chiara ; Fantola, Giovanni ; Zamboni, Fausto ; Piredda, Gian Benedetto ; Michittu, Maria Benigna ; Murgia, Maria Gavina ; Onano, Bruno ; Fratino, Lucia ; Maso, Luigino Dal ; De Paoli, Paolo ; Verdirosi, Diana ; Vaccher, Emanuela ; Pisani, Francesco ; Famulari, Antonio ; Delreno, Federica ; Iesari, Samuele ; De Luca, Linda ; Iaria, Maurizio ; Capocasale, Enzo ; Cremaschi, Elena ; Sandrini, Silvio ; Valerio, Francesca ; Mazzucotelli, Valentina ; Bossini, Nicola ; Setti, Gisella ; Veroux, Massimiliano ; Veroux, Pierfrancesco ; Giaquinta, Alessia ; Zerbo, Domenico ; Busnach, Ghil ; Di Leo, Laura ; Perrino, Maria Luisa ; Querques, Marialuisa ; Colombo, Valeriana ; Sghirlanzoni, Maria Chiara ; Messa, Piergiorgio ; Leoni, Antonio ; Galatioto, Laura ; Gruttadauria, Salvatore ; Sparacino, Vito ; Caputo, Flavia ; Buscemi, Barbara ; Spagnoletti, Gionata ; Salerno, Maria Paola ; Favi, Evaldo ; Segoloni, Giuseppe Paolo ; Biancone, Luigi ; Lavacca, Antonio ; Maresca, Maria Cristina ; Cascone, Carmelo ; Virgilio, Bice ; Donati, Donato ; Dossi, Fiorella ; Fontanella, Andrea ; Ambrosini, Andrea ; Di Cicco, Marco. / Increased cancer risk in patients undergoing dialysis : A population-based cohort study in North-Eastern Italy. In: BMC Nephrology. 2019 ; Vol. 20, No. 1. pp. 1-8.
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title = "Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy",
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.",
keywords = "Cancer risk, de novo malignancies, Dialysis, End-stage kidney disease, Italy, Population-based study",
author = "Martina Taborelli and Federica Toffolutti and {Del Zotto}, Stefania and Elena Clagnan and Lucrezia Furian and Pierluca Piselli and Franco Citterio and Loris Zanier and Giuliano Boscutti and Diego Serraino and Sarah Shalaby and Raffaella Petrara and Patrizia Burra and Giacomo Zanus and Stefano Zanini and Paolo Rigotti and Maria Rendina and {Di Leo}, Alfredo and Schena, {Francesco Paolo} and Giuseppe Grandaliano and Marco Fiorentino and Augusto Lauro and Pinna, {Antonio Daniele} and {Di Gioia}, Paolo and Sara Pellegrini and Chiara Zanfi and Scolari, {Maria Piera} and Sergio Stefoni and Paola Todeschini and Laura Panicali and Chiara Valentini and Umberto Baccarani and Andrea Risaliti and Adani, {Gian Luigi} and Dario Lorenzin and Ettorre, {Giuseppe Maria} and Giovanni Vennarecci and Marco Colasanti and Manuela Coco and Fabrizio Ettorre and Roberto Santoro and Lucia Miglioresi and Francesco Nudo and Massimo Rossi and Gianluca Mennini and Luca Toti and Giuseppe Tisone and Annachiara Casella and Laura Fazzolari and Daniele Sforza and Giuseppe Iaria and Carlo Gazia and Chiara Belardi and Claudia Cimaglia and Alessandro Agresta and Gianpiero D'Offizi and Comandini, {Ubaldo Visco} and Raffaella Lionetti and Marzia Montalbano and Chiara Taibi and Giovanni Fantola and Fausto Zamboni and Piredda, {Gian Benedetto} and Michittu, {Maria Benigna} and Murgia, {Maria Gavina} and Bruno Onano and Lucia Fratino and Maso, {Luigino Dal} and {De Paoli}, Paolo and Diana Verdirosi and Emanuela Vaccher and Francesco Pisani and Antonio Famulari and Federica Delreno and Samuele Iesari and {De Luca}, Linda and Maurizio Iaria and Enzo Capocasale and Elena Cremaschi and Silvio Sandrini and Francesca Valerio and Valentina Mazzucotelli and Nicola Bossini and Gisella Setti and Massimiliano Veroux and Pierfrancesco Veroux and Alessia Giaquinta and Domenico Zerbo and Ghil Busnach and {Di Leo}, Laura and Perrino, {Maria Luisa} and Marialuisa Querques and Valeriana Colombo and Sghirlanzoni, {Maria Chiara} and Piergiorgio Messa and Antonio Leoni and Laura Galatioto and Salvatore Gruttadauria and Vito Sparacino and Flavia Caputo and Barbara Buscemi and Gionata Spagnoletti and Salerno, {Maria Paola} and Evaldo Favi and Segoloni, {Giuseppe Paolo} and Luigi Biancone and Antonio Lavacca and Maresca, {Maria Cristina} and Carmelo Cascone and Bice Virgilio and Donato Donati and Fiorella Dossi and Andrea Fontanella and Andrea Ambrosini and {Di Cicco}, Marco",
year = "2019",
month = "3",
day = "28",
doi = "10.1186/s12882-019-1283-4",
language = "English",
volume = "20",
pages = "1--8",
journal = "BMC Nephrology",
issn = "1471-2369",
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TY - JOUR

T1 - Increased cancer risk in patients undergoing dialysis

T2 - A population-based cohort study in North-Eastern Italy

AU - Taborelli, Martina

AU - Toffolutti, Federica

AU - Del Zotto, Stefania

AU - Clagnan, Elena

AU - Furian, Lucrezia

AU - Piselli, Pierluca

AU - Citterio, Franco

AU - Zanier, Loris

AU - Boscutti, Giuliano

AU - Serraino, Diego

AU - Shalaby, Sarah

AU - Petrara, Raffaella

AU - Burra, Patrizia

AU - Zanus, Giacomo

AU - Zanini, Stefano

AU - Rigotti, Paolo

AU - Rendina, Maria

AU - Di Leo, Alfredo

AU - Schena, Francesco Paolo

AU - Grandaliano, Giuseppe

AU - Fiorentino, Marco

AU - Lauro, Augusto

AU - Pinna, Antonio Daniele

AU - Di Gioia, Paolo

AU - Pellegrini, Sara

AU - Zanfi, Chiara

AU - Scolari, Maria Piera

AU - Stefoni, Sergio

AU - Todeschini, Paola

AU - Panicali, Laura

AU - Valentini, Chiara

AU - Baccarani, Umberto

AU - Risaliti, Andrea

AU - Adani, Gian Luigi

AU - Lorenzin, Dario

AU - Ettorre, Giuseppe Maria

AU - Vennarecci, Giovanni

AU - Colasanti, Marco

AU - Coco, Manuela

AU - Ettorre, Fabrizio

AU - Santoro, Roberto

AU - Miglioresi, Lucia

AU - Nudo, Francesco

AU - Rossi, Massimo

AU - Mennini, Gianluca

AU - Toti, Luca

AU - Tisone, Giuseppe

AU - Casella, Annachiara

AU - Fazzolari, Laura

AU - Sforza, Daniele

AU - Iaria, Giuseppe

AU - Gazia, Carlo

AU - Belardi, Chiara

AU - Cimaglia, Claudia

AU - Agresta, Alessandro

AU - D'Offizi, Gianpiero

AU - Comandini, Ubaldo Visco

AU - Lionetti, Raffaella

AU - Montalbano, Marzia

AU - Taibi, Chiara

AU - Fantola, Giovanni

AU - Zamboni, Fausto

AU - Piredda, Gian Benedetto

AU - Michittu, Maria Benigna

AU - Murgia, Maria Gavina

AU - Onano, Bruno

AU - Fratino, Lucia

AU - Maso, Luigino Dal

AU - De Paoli, Paolo

AU - Verdirosi, Diana

AU - Vaccher, Emanuela

AU - Pisani, Francesco

AU - Famulari, Antonio

AU - Delreno, Federica

AU - Iesari, Samuele

AU - De Luca, Linda

AU - Iaria, Maurizio

AU - Capocasale, Enzo

AU - Cremaschi, Elena

AU - Sandrini, Silvio

AU - Valerio, Francesca

AU - Mazzucotelli, Valentina

AU - Bossini, Nicola

AU - Setti, Gisella

AU - Veroux, Massimiliano

AU - Veroux, Pierfrancesco

AU - Giaquinta, Alessia

AU - Zerbo, Domenico

AU - Busnach, Ghil

AU - Di Leo, Laura

AU - Perrino, Maria Luisa

AU - Querques, Marialuisa

AU - Colombo, Valeriana

AU - Sghirlanzoni, Maria Chiara

AU - Messa, Piergiorgio

AU - Leoni, Antonio

AU - Galatioto, Laura

AU - Gruttadauria, Salvatore

AU - Sparacino, Vito

AU - Caputo, Flavia

AU - Buscemi, Barbara

AU - Spagnoletti, Gionata

AU - Salerno, Maria Paola

AU - Favi, Evaldo

AU - Segoloni, Giuseppe Paolo

AU - Biancone, Luigi

AU - Lavacca, Antonio

AU - Maresca, Maria Cristina

AU - Cascone, Carmelo

AU - Virgilio, Bice

AU - Donati, Donato

AU - Dossi, Fiorella

AU - Fontanella, Andrea

AU - Ambrosini, Andrea

AU - Di Cicco, Marco

PY - 2019/3/28

Y1 - 2019/3/28

N2 - 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.

AB - 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.

KW - Cancer risk

KW - de novo malignancies

KW - Dialysis

KW - End-stage kidney disease

KW - Italy

KW - Population-based study

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