Risk of Thyroid Cancer Among Solid Organ Transplant Recipients

C. M. Kitahara, E. L. Yanik, P. W. Ladenson, B. Y. Hernandez, C. F. Lynch, K. S. Pawlish, E. A. Engels

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Solid organ transplant recipients have an elevated incidence of thyroid cancer. We evaluated a wide range of potential risk factors in a cohort of 229 300 U.S. solid organ transplant recipients linked with 15 stage/regional cancer registries (1987–2012). Incidence rate ratios (IRRs) were adjusted for age, sex, race/ethnicity, transplanted organ, year of transplantation, and time since transplantation. Hazard ratios (HRs) for death and/or graft failure were adjusted for age, sex, race/ethnicity, transplanted organ, and year of transplantation. After transplantation, 356 thyroid cancers were diagnosed. Thyroid cancer incidence was 2.50-fold higher in transplant recipients than the general population (95% confidence interval [CI] 2.25–2.77). Among recipients of different organs, kidney recipients had the highest incidence of thyroid cancer (IRR = 1.26, 95% CI 1.03–1.53). Elevated thyroid cancer incidence was associated with cholestatic liver disease/cirrhosis as an indication for liver transplantation (IRR = 1.69, 95% CI 1.09–2.63), hypertensive nephrosclerosis as an indication for kidney transplantation (IRR = 1.41, 95% CI 1.03–1.94), and longer prior dialysis among kidney recipients (5+ vs. <1 year, IRR = 1.92, 95% CI 1.32–2.80; p-trend <0.01). Posttransplantation diagnosis of thyroid cancer was associated with modestly increased risk of death (HR = 1.33, 95% CI 1.02–1.73). Overall, our results suggest that end-stage organ disease and longer duration of dialysis may contribute to higher thyroid cancer incidence in transplant recipients.

Original languageEnglish
Pages (from-to)2911-2921
Number of pages11
JournalAmerican Journal of Transplantation
Volume17
Issue number11
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • cancer/malignancy/neoplasia: risk factors
  • clinical research/practice
  • epidemiology
  • immunosuppression/immune modulation
  • kidney transplantation/nephrology
  • organ transplantation in general
  • translational research/science

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  • Cite this

    Kitahara, C. M., Yanik, E. L., Ladenson, P. W., Hernandez, B. Y., Lynch, C. F., Pawlish, K. S., & Engels, E. A. (2017). Risk of Thyroid Cancer Among Solid Organ Transplant Recipients. American Journal of Transplantation, 17(11), 2911-2921. https://doi.org/10.1111/ajt.14310