Lung cancer, non-Hodgkin lymphoma biggest contributors to life-years lost to cancer in transplant patients
NEW YORK 21/09- Transplant recipients have a shortened lifespan after developing cancer, especially those who develop lung cancer and non-Hodgkin lymphoma (NHL), according to a new analysis.
Organ-transplant recipients face an elevated risk of developing cancer, relative to the general population, due to immunosuppressive medications they must take to prevent organ rejection, as well as underlying medical conditions.
Dr. Anne-Michelle Noone, of the Division of Cancer Control and Population Sciences at the National Cancer Institute in Bethesda, Maryland, and colleagues quantified the life-years lost (LYL) due to cancer among U.S. transplant recipients over the first 10 years following the transplant.
Data for the analysis came from organ-transplant- and cancer-registry data in the United States for the period 1987 to 2014.
Among nearly 222,000 transplant recipients, 6% developed cancer within 10 years of transplantation. During this period, an average of 0.16 years of life per person was lost to cancer, the authors found.
"Although this may seem like a small amount, the LYL per person translated into 1.9% of all life-years among this population expected in the absence of cancer or, equivalently, 11% of all LYL due to any cause," they write in the journal Cancer.
Lung cancer and NHL had the highest impact on LYL after transplantation, responsible for 39% of the total LYL due to cancer. Individually, once a transplant recipient developed either lung cancer or NHL, they lost an average of almost five years of life.
LYL due to cancer increased with age and lung-transplant patients had the highest LYL due to cancer, followed by heart-transplant recipients.
"There are opportunities to reduce cancer mortality and extend the lives of transplant recipients through prevention and screening. Because large proportions of LYL are caused to NHL and lung cancer, these cancers should be a priority," the authors write.
"High levels of circulating Epstein-Barr virus load can be used as a marker of post transplant lymphoproliferative disorder risk, providing potential opportunities to screen for NHL, especially in pediatric recipients," they say.
"Following the recommendations for lung cancer screening in the general population, transplant providers should consider screening older transplant recipients with a smoking history using low-dose computed tomography. Finally, cancer prevention strategies aimed at modifying lifestyle risk factors, especially smoking cessation, should be prioritized to reduce cancer mortality," they conclude.
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