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Risk of Thyroid Cancer Among Solid Organ Transplant Recipients.

Risk of Thyroid Cancer Among Solid Organ Transplant Recipients.
Author Information (click to view)

Kitahara CM, Yanik EL, Ladenson PW, Hernandez BY, Lynch CF, Pawlish KS, Engels EA,


Kitahara CM, Yanik EL, Ladenson PW, Hernandez BY, Lynch CF, Pawlish KS, Engels EA, (click to view)

Kitahara CM, Yanik EL, Ladenson PW, Hernandez BY, Lynch CF, Pawlish KS, Engels EA,

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American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2017 05 3017(11) 2911-2921 doi 10.1111/ajt.14310

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.

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