所属 医学部 医学科（東京女子医科大学病院） 職種 非常勤講師
|発表タイトル||Standardized incidence ratios of cancers in renal transplant recipients in Japan: a single center study for 40 years|
|会議名||American Transpalnt Congress 2013|
|発表者・共同発表者||◎Iwadoh Kazuhiro, Kai Kotaro, Sannomiya Akihito, Murakami Toru, Kitajima Kumiko, Koyama Ichiro, Nakajima Ichiro, Hattori Motoshi, Tanabe Kazunari, Fuchinoue Shohei|
|概要||【Background】Renal transplant recipients under immunosuppression carry a higher risk of developing cancers than general population. There were, however, few reports from Asia that revealed incidence-rate ratios of cancers in each organ compared with those of general population.
【Method】Cancer incidences in patients who underwent renal transplantation (RTx) in our institution were retrospectively reviewed. Standardized Incidence Ratio (SIR) of them for each organ was estimated using Poisson regression compared with cancer incidence rates in Japanese general population reported by Center for Cancer Control and Information Services, National Cancer Center (NCC), Japan. Expected numbers of cancers in general population in accordance with RTx patients were figured out as age-specific, sex-specific, calendar year-specific, organ-specific and observation time-specific caner incidence.
【Result】2411 RTx were performed from 1971 to 2007. The total observation time was 21,014.6 person-years. 144 cancers were detected, including 14 double cancers and 2 triple cancers. 3 renal graft cancers, 1 retroperitoneal cancer and 1 testicular cancer were excluded from the analysis of SIR because there were no counter parts in cancer data from NCC. Average age of recipients at RTx and the onset of a cancer were 34.8±13.8, 51.8±11.5, respectively. Overall raw cancer incidence rate was 5.97%. SIR of them on all organs were 2.39±0.38 (Table). High SIR(>5) sites included kidney, skin, brain and PTLD. Low SIR(<1) organs included lung, esophagus and prostate. Although SIR of uterus was 3.43±2.24, that of uterine corpus was as high as 13.0±15.7 while that of uterine cervix was 2.44±4.42.
【Conclusion】The relative risk of developing malignancy after RTx was 2.39±0.38. Kidney, skin and uterine corpus showed as high SIR as >10. SIR of most organs ranged from 1 to 5. SIR of prevalent cancers in Japanese general population, including stomach and colon, were relatively as low as 1 to 2, while breast and uterus were around 3.0 to 3.4.