From the Guidelines
Kidney transplant recipients are at increased risk for colon cancer, as consistent evidence of increased incidence in SOTRs exists only for colorectal cancer. This increased risk stems from the immunosuppressive medications that transplant recipients must take to prevent organ rejection, which suppress the immune system's ability to identify and destroy abnormal cells, including cancer cells 1. The risk is particularly elevated for cancers with viral associations. Additionally, the risk increases with the duration and intensity of immunosuppression.
Some of the key points to consider include:
- The risk of skin cancer is especially high, with squamous cell carcinoma being more common in transplant recipients than in the general population 1.
- Transplant recipients should undergo more frequent cancer screenings, including regular colonoscopies, mammograms, Pap smears, and chest imaging as recommended by their transplant team 1.
- The risk of cervical cancer is increased in kidney transplant recipients, with a standardized incidence ratio of 7.19 (3.8-13.4) 1.
- The risk of other cancers, such as lung cancer, breast cancer, and uterine cancer, may also be increased in kidney transplant recipients, but the evidence is not as strong as it is for colon cancer 1.
It is essential to note that the risk of cancer in kidney transplant recipients is a significant concern, and regular cancer screenings are crucial to detect and treat cancer early. Patients should practice strict sun protection, perform regular skin self-examinations, and have annual dermatology check-ups to monitor for skin cancers.
In terms of specific cancer risks, the evidence suggests that:
- Colorectal cancer risk is increased in kidney transplant recipients, with a standardized incidence ratio of 1.75 (1.2-2.5) 1.
- Cervical cancer risk is increased in kidney transplant recipients, with a standardized incidence ratio of 7.19 (3.8-13.4) 1.
- Lung cancer risk may be increased in kidney transplant recipients, but the evidence is not as strong as it is for colon cancer, with a standardized incidence ratio of 1.68 (1.2-2.4) 1.
- Breast cancer risk may be increased in kidney transplant recipients, but the evidence is not as strong as it is for colon cancer, with a standardized incidence ratio of 1.66 (1.2-2.7) 1.
- Uterine cancer risk may be increased in kidney transplant recipients, but the evidence is not as strong as it is for colon cancer, with a standardized incidence ratio of 1.44 (0.5-4.5) 1.
From the Research
Cancer Risk in Kidney Transplant Recipients
- Kidney transplant recipients are at increased risk for various types of cancer due to immunosuppression and oncogenic viral infections 2, 3, 4.
- The most common malignancies with elevated risk in solid organ transplant recipients include non-Hodgkin lymphoma, lung cancer, liver cancer, and kidney cancer 2.
- Lung cancer risk is increased in kidney transplant recipients, with a standardized incidence ratio (SIR) of 1.46 2.
- Breast, prostate, lung, and colorectal cancers are not significantly increased in kidney transplant recipients, or are only mildly increased 3.
- Kidney transplant recipients have an increased risk of kidney cancer, with a SIR of 6.66 2.
Specific Cancer Risks
- Lung cancer: increased risk in kidney transplant recipients, with a SIR of 1.46 2.
- Colon cancer: not significantly increased in kidney transplant recipients 3.
- Breast cancer: not significantly increased in kidney transplant recipients 3.
- Uterine cancer: no specific information available in the provided studies.
Immunossuppression and Cancer Risk
- Chronic immunosuppression in kidney transplant recipients leads to an increased risk of skin cancers, including nonmelanoma skin cancers and melanoma 5, 6.
- Immunosuppression also increases the risk of other types of cancer, including viral-mediated cancers such as post-transplant lymphoproliferative disorder, anogenital cancers, and Kaposi sarcoma 3, 4.