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Risk of virus and non-virus related malignancies following immunosuppression in a cohort of liver transplant recipients. Italy, 1985-2014
- Publication Year :
- 2018
- Publisher :
- Wiley-Liss Inc., 2018.
-
Abstract
- This cohort study assessed, in Italy, the overall pattern of risk of de novo malignancies following liver transplantation (LT). The study group included 2,832 individuals who underwent LT between 1985 and 2014 in nine centers all over Italy. Person-years (PYs) at cancer risk were computed from 30 days after LT to the date of cancer diagnosis, to the date of death or to the end of follow-up. Excess cancer risk, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). During 18,642 PYs, 246 LT recipients developed 266 de novo malignancies, corresponding to a 1.8-fold higher cancer risk (95% CI: 1.6-2.0). SIRs were particularly elevated for virus-related malignancies, including Kaposi's sarcoma (SIR = 53.6, 95% CI: 30.0-88.5), non-Hodgkin lymphomas (SIR = 7.1, 95% CI: 4.8-10.1) and cervix uteri (SIR = 5.4, 95% CI: 1.1-15.8). Among virus-unrelated malignancies, elevated risks emerged for head and neck (SIR = 4.4, 95% CI: 3.1-6.2), esophagus (SIR = 6.7, 95% CI: 2.9-13.3) and adrenal gland (SIR = 22.9, 95% CI: 2.8-82.7). Borderline statistically significant elevated risks were found for lung cancer (SIR = 1.4, 95% CI: 1.0-2.1) and skin melanoma (SIR = 2.6, 95% CI: 1.0-5.3). A reduced risk emerged for prostate cancer (SIR = 0.1, 95% CI: 0.0-0.5). These findings underline the need of preventive interventions and early detection of malignancies, specifically tailored to LT recipients.
- Subjects :
- Male
Cancer Research
Time Factors
Cancer risk
Cohort study
Immunosuppression
Italy
Liver transplantation
Viral infection
Oncology
medicine.medical_treatment
cancer risk
cohort study
immunosuppression
liver transplantation
viral infection
030230 surgery
Gastroenterology
0302 clinical medicine
Risk Factors
Neoplasms
Prospective Studies
education.field_of_study
Incidence (epidemiology)
Incidence
Middle Aged
Prognosis
Virus Diseases
030220 oncology & carcinogenesis
Cohort
Female
Adult
medicine.medical_specialty
Adolescent
Population
03 medical and health sciences
Young Adult
Internal medicine
medicine
Immune Tolerance
Humans
Lung cancer
education
Immunosuppression Therapy
Follow-Up Studies
Liver Transplantation
business.industry
Cancer
medicine.disease
Settore MED/18
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....e58c31f2cbe8f0dca3115f9bed872279