Trapianto di rene e rischio di cancro

Studio epidemiologico in Nord e Centro Italia

Translated title of the contribution: Kidney transplant and cancer risk: An epidemiological study in Northern and Central Italy

Pierluca Piselli, Ghil Busnach, Franco Citterio, Lorenzo Richiardi, Claudia Cimaglia, Claudio Angeletti, Patrizia V. Doringhet, Ubaldo Pozzetto, Maria L. Perrino, Diego Serraino

Research output: Contribution to journalArticle

Abstract

Objective: this investigation aimed at highlighting the cancer risk of recipients ofkidney transplant in northern and central Italy. Methods: data on 2,120 kidney transplant recipients from Niguarda Ca' Granda Hospital, Milan, or from Policlinico «A. Gemelli», Rome, were analyzed. The period at risk of developing cancer (person-years, PY) was computed from 30 days after transplant to date of cancer diagnosis, or date of death, or date of re-entering dialysis, or date of last follow-up. Observed and expected numbers of cancer were compared through sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). The transplant attributable fraction (AF) of cancer cases and incidence rate ratios (IRR) were also computed. Results: after 16.594PY of follow-up (median follow-up: 6.8 years), 121 cancer cases were diagnosed (729.2 cases/105 PY). The SIR for all cancers was 1.9. Kaposi's sarcoma (KS) (27 cases observed, SIR=82) and non-Hodgkin's lymphoma (NHL) (18 cases observed SIR=6.4) were the most common cancers. Significantly increased SIRs were also noted for native kidney (11 cases observed SIR=4.9), corpus uteri (6 cases observed SIR=4.6), and liver (6 cases observed SIR=3.1). The transplant AF was 46.9%, largely due to KS (98.8%) and NHL (84.3%). Since SIRs decreased with increasing age, the transplant AF ranged from 73.2% below 45 years of age to 30.4% after 54. Among risk factors, area of birth strongly influenced the risk of KS, with a 3-fold higher risk in those born in the South of Italy as compared to those born in the northern part. Conclusions: immune depression after kidney transplantation entails a two-fold increased overall risk of cancer, mainly related to cancers associated to a viral aetiology. Furthermore, our findings suggest the need to adopt a specific serological screening for the prevention of post-transplant KS in individuals born in southern Italy.

Original languageItalian
Pages (from-to)205-211
Number of pages7
JournalEpidemiologia e prevenzione
Volume32
Issue number4-5
Publication statusPublished - Jul 2008

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Kidney Neoplasms
Italy
Epidemiologic Studies
Transplants
Incidence
Kaposi's Sarcoma
Neoplasms
Non-Hodgkin's Lymphoma
Kidney
Kidney Transplantation
Uterus
Dialysis
Parturition
Confidence Intervals

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Trapianto di rene e rischio di cancro : Studio epidemiologico in Nord e Centro Italia. / Piselli, Pierluca; Busnach, Ghil; Citterio, Franco; Richiardi, Lorenzo; Cimaglia, Claudia; Angeletti, Claudio; Doringhet, Patrizia V.; Pozzetto, Ubaldo; Perrino, Maria L.; Serraino, Diego.

In: Epidemiologia e prevenzione, Vol. 32, No. 4-5, 07.2008, p. 205-211.

Research output: Contribution to journalArticle

Piselli, P, Busnach, G, Citterio, F, Richiardi, L, Cimaglia, C, Angeletti, C, Doringhet, PV, Pozzetto, U, Perrino, ML & Serraino, D 2008, 'Trapianto di rene e rischio di cancro: Studio epidemiologico in Nord e Centro Italia', Epidemiologia e prevenzione, vol. 32, no. 4-5, pp. 205-211.
Piselli, Pierluca ; Busnach, Ghil ; Citterio, Franco ; Richiardi, Lorenzo ; Cimaglia, Claudia ; Angeletti, Claudio ; Doringhet, Patrizia V. ; Pozzetto, Ubaldo ; Perrino, Maria L. ; Serraino, Diego. / Trapianto di rene e rischio di cancro : Studio epidemiologico in Nord e Centro Italia. In: Epidemiologia e prevenzione. 2008 ; Vol. 32, No. 4-5. pp. 205-211.
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abstract = "Objective: this investigation aimed at highlighting the cancer risk of recipients ofkidney transplant in northern and central Italy. Methods: data on 2,120 kidney transplant recipients from Niguarda Ca' Granda Hospital, Milan, or from Policlinico «A. Gemelli», Rome, were analyzed. The period at risk of developing cancer (person-years, PY) was computed from 30 days after transplant to date of cancer diagnosis, or date of death, or date of re-entering dialysis, or date of last follow-up. Observed and expected numbers of cancer were compared through sex- and age-standardized incidence ratios (SIRs) and 95{\%} confidence intervals (CIs). The transplant attributable fraction (AF) of cancer cases and incidence rate ratios (IRR) were also computed. Results: after 16.594PY of follow-up (median follow-up: 6.8 years), 121 cancer cases were diagnosed (729.2 cases/105 PY). The SIR for all cancers was 1.9. Kaposi's sarcoma (KS) (27 cases observed, SIR=82) and non-Hodgkin's lymphoma (NHL) (18 cases observed SIR=6.4) were the most common cancers. Significantly increased SIRs were also noted for native kidney (11 cases observed SIR=4.9), corpus uteri (6 cases observed SIR=4.6), and liver (6 cases observed SIR=3.1). The transplant AF was 46.9{\%}, largely due to KS (98.8{\%}) and NHL (84.3{\%}). Since SIRs decreased with increasing age, the transplant AF ranged from 73.2{\%} below 45 years of age to 30.4{\%} after 54. Among risk factors, area of birth strongly influenced the risk of KS, with a 3-fold higher risk in those born in the South of Italy as compared to those born in the northern part. Conclusions: immune depression after kidney transplantation entails a two-fold increased overall risk of cancer, mainly related to cancers associated to a viral aetiology. Furthermore, our findings suggest the need to adopt a specific serological screening for the prevention of post-transplant KS in individuals born in southern Italy.",
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AU - Citterio, Franco

AU - Richiardi, Lorenzo

AU - Cimaglia, Claudia

AU - Angeletti, Claudio

AU - Doringhet, Patrizia V.

AU - Pozzetto, Ubaldo

AU - Perrino, Maria L.

AU - Serraino, Diego

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N2 - Objective: this investigation aimed at highlighting the cancer risk of recipients ofkidney transplant in northern and central Italy. Methods: data on 2,120 kidney transplant recipients from Niguarda Ca' Granda Hospital, Milan, or from Policlinico «A. Gemelli», Rome, were analyzed. The period at risk of developing cancer (person-years, PY) was computed from 30 days after transplant to date of cancer diagnosis, or date of death, or date of re-entering dialysis, or date of last follow-up. Observed and expected numbers of cancer were compared through sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). The transplant attributable fraction (AF) of cancer cases and incidence rate ratios (IRR) were also computed. Results: after 16.594PY of follow-up (median follow-up: 6.8 years), 121 cancer cases were diagnosed (729.2 cases/105 PY). The SIR for all cancers was 1.9. Kaposi's sarcoma (KS) (27 cases observed, SIR=82) and non-Hodgkin's lymphoma (NHL) (18 cases observed SIR=6.4) were the most common cancers. Significantly increased SIRs were also noted for native kidney (11 cases observed SIR=4.9), corpus uteri (6 cases observed SIR=4.6), and liver (6 cases observed SIR=3.1). The transplant AF was 46.9%, largely due to KS (98.8%) and NHL (84.3%). Since SIRs decreased with increasing age, the transplant AF ranged from 73.2% below 45 years of age to 30.4% after 54. Among risk factors, area of birth strongly influenced the risk of KS, with a 3-fold higher risk in those born in the South of Italy as compared to those born in the northern part. Conclusions: immune depression after kidney transplantation entails a two-fold increased overall risk of cancer, mainly related to cancers associated to a viral aetiology. Furthermore, our findings suggest the need to adopt a specific serological screening for the prevention of post-transplant KS in individuals born in southern Italy.

AB - Objective: this investigation aimed at highlighting the cancer risk of recipients ofkidney transplant in northern and central Italy. Methods: data on 2,120 kidney transplant recipients from Niguarda Ca' Granda Hospital, Milan, or from Policlinico «A. Gemelli», Rome, were analyzed. The period at risk of developing cancer (person-years, PY) was computed from 30 days after transplant to date of cancer diagnosis, or date of death, or date of re-entering dialysis, or date of last follow-up. Observed and expected numbers of cancer were compared through sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). The transplant attributable fraction (AF) of cancer cases and incidence rate ratios (IRR) were also computed. Results: after 16.594PY of follow-up (median follow-up: 6.8 years), 121 cancer cases were diagnosed (729.2 cases/105 PY). The SIR for all cancers was 1.9. Kaposi's sarcoma (KS) (27 cases observed, SIR=82) and non-Hodgkin's lymphoma (NHL) (18 cases observed SIR=6.4) were the most common cancers. Significantly increased SIRs were also noted for native kidney (11 cases observed SIR=4.9), corpus uteri (6 cases observed SIR=4.6), and liver (6 cases observed SIR=3.1). The transplant AF was 46.9%, largely due to KS (98.8%) and NHL (84.3%). Since SIRs decreased with increasing age, the transplant AF ranged from 73.2% below 45 years of age to 30.4% after 54. Among risk factors, area of birth strongly influenced the risk of KS, with a 3-fold higher risk in those born in the South of Italy as compared to those born in the northern part. Conclusions: immune depression after kidney transplantation entails a two-fold increased overall risk of cancer, mainly related to cancers associated to a viral aetiology. Furthermore, our findings suggest the need to adopt a specific serological screening for the prevention of post-transplant KS in individuals born in southern Italy.

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