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Kim B, Kang M, Kim Y, Lee HS, Kim B, Lee JJ, Park Y, Lee KA. De Novo Cancer Incidence after Kidney Transplantation in South Korea from 2002 to 2017. J Clin Med 2021; 10:jcm10163530. [PMID: 34441826 PMCID: PMC8396914 DOI: 10.3390/jcm10163530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 12/26/2022] Open
Abstract
Advances in patient care and immunosuppressive drugs have improved graft survival, resulting in an increase in kidney transplantation (KT); however, persistent immunosuppression is thought to cause late occurrence of cancer. This population-based study consisted of a total of 14,842 patients whose data from the years 2002 to 2017 were collected from the National Health Information Database in South Korea. Malignancies occurred in 7.6% of the total KT patients. Prostate and thyroid cancers were the most common in males and females, respectively. From the age-adjusted incidence analysis, Kaposi’s sarcoma showed the highest standardized incidence ratio in both male and female patients. According to the linear regression model, cancer incidence in KT recipients under immunosuppressive conditions increased by approximately 0.1% each month. Patients’ age over 39 and the use of prednisolone as an initial steroid regimen were associated with increased risk of cancer development after KT. Our regression and proportional hazards models will help clinicians to predict the approximate cancer incidence risk when monitoring KT recipients. Based on the largest available national database, screening or monitoring methods for cancer detection and prevention can be established for KT patients by considering the factors involved in cancer development.
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Affiliation(s)
- Boyeon Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Korea; (B.K.); (B.K.)
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea; (Y.K.); (K.-A.L.)
| | - Minjin Kang
- Research Institute, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea;
| | - Yoonjung Kim
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea; (Y.K.); (K.-A.L.)
| | - Hyung Soon Lee
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea;
| | - Banseok Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Korea; (B.K.); (B.K.)
| | - Jung Jun Lee
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
- Correspondence: (J.J.L.); (Y.P.); Tel.: +82-2-2019-3533 (Y.P.)
| | - Yongjung Park
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Korea; (B.K.); (B.K.)
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea; (Y.K.); (K.-A.L.)
- Correspondence: (J.J.L.); (Y.P.); Tel.: +82-2-2019-3533 (Y.P.)
| | - Kyung-A Lee
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea; (Y.K.); (K.-A.L.)
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