Risk of cancer after lung transplantation for COPD
(2017) In International Journal of COPD 12. p.2841-2847- Abstract
Background: The risk of cancer is increased and affects survival after lung transplantation (LTx), but has not been well characterized in COPD. We aimed to evaluate the incidence and prognosis of cancer following LTx for COPD. Methods: A prospective, population-based study of patients undergoing LTx for end-stage COPD at the two transplantation centers in Sweden between 1990−2013, with follow-up for incident cancer and death, using national registers. The excess risk of cancer was calculated as standardized incidence ratios compared with the general population matched for age, sex, and calendar year. Risk factors for cancer were analyzed using Fine-Gray regression, and survival after cancer diagnosis with Kaplan-Meier. Results: In... (More)
Background: The risk of cancer is increased and affects survival after lung transplantation (LTx), but has not been well characterized in COPD. We aimed to evaluate the incidence and prognosis of cancer following LTx for COPD. Methods: A prospective, population-based study of patients undergoing LTx for end-stage COPD at the two transplantation centers in Sweden between 1990−2013, with follow-up for incident cancer and death, using national registers. The excess risk of cancer was calculated as standardized incidence ratios compared with the general population matched for age, sex, and calendar year. Risk factors for cancer were analyzed using Fine-Gray regression, and survival after cancer diagnosis with Kaplan-Meier. Results: In total, 331 patients (mean age 55.4 years; 64% women; 97% former smokers) were included. At a median follow-up of 2.8 years, 35% of patients had developed cancer and the risk was increased more than 10-fold ([95% CI] 8.1−11.8). The highest excess risks were for non-Hodgkin lymphoma (20.8−66.7), skin cancer (20.3−35.2), lung (11.7−31.2), liver (3.6−51.6), and colorectal cancer (6.1−19.5). Median survival was longer for skin cancer (8 years; 95% CI, 3−15) compared with non-skin cancer (4 years; 95% CI, 2.8−4.8; p<0.001). Conclusion: The cancer risk is markedly increased after LTx for COPD. It could not be predicted by the factors evaluated, but contributed significantly to a negative prognosis.
(Less)
- author
- Ekström, Magnus LU ; Riise, Gerdt C and Tanash, Hanan A. LU
- organization
- publishing date
- 2017-10-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cancer, COPD, Lung transplantation, Severe alpha-1-antitrypsin deficiency, Survival
- in
- International Journal of COPD
- volume
- 12
- pages
- 7 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- scopus:85031086073
- wos:000412397000002
- pmid:29042765
- ISSN
- 1176-9106
- DOI
- 10.2147/COPD.S147065
- language
- English
- LU publication?
- yes
- id
- 904ecb7e-474c-4349-9e66-1e80b9de2217
- date added to LUP
- 2017-11-02 14:17:19
- date last changed
- 2024-05-27 01:48:25
@article{904ecb7e-474c-4349-9e66-1e80b9de2217, abstract = {{<p>Background: The risk of cancer is increased and affects survival after lung transplantation (LTx), but has not been well characterized in COPD. We aimed to evaluate the incidence and prognosis of cancer following LTx for COPD. Methods: A prospective, population-based study of patients undergoing LTx for end-stage COPD at the two transplantation centers in Sweden between 1990−2013, with follow-up for incident cancer and death, using national registers. The excess risk of cancer was calculated as standardized incidence ratios compared with the general population matched for age, sex, and calendar year. Risk factors for cancer were analyzed using Fine-Gray regression, and survival after cancer diagnosis with Kaplan-Meier. Results: In total, 331 patients (mean age 55.4 years; 64% women; 97% former smokers) were included. At a median follow-up of 2.8 years, 35% of patients had developed cancer and the risk was increased more than 10-fold ([95% CI] 8.1−11.8). The highest excess risks were for non-Hodgkin lymphoma (20.8−66.7), skin cancer (20.3−35.2), lung (11.7−31.2), liver (3.6−51.6), and colorectal cancer (6.1−19.5). Median survival was longer for skin cancer (8 years; 95% CI, 3−15) compared with non-skin cancer (4 years; 95% CI, 2.8−4.8; p<0.001). Conclusion: The cancer risk is markedly increased after LTx for COPD. It could not be predicted by the factors evaluated, but contributed significantly to a negative prognosis.</p>}}, author = {{Ekström, Magnus and Riise, Gerdt C and Tanash, Hanan A.}}, issn = {{1176-9106}}, keywords = {{Cancer; COPD; Lung transplantation; Severe alpha-1-antitrypsin deficiency; Survival}}, language = {{eng}}, month = {{10}}, pages = {{2841--2847}}, publisher = {{Dove Medical Press Ltd.}}, series = {{International Journal of COPD}}, title = {{Risk of cancer after lung transplantation for COPD}}, url = {{http://dx.doi.org/10.2147/COPD.S147065}}, doi = {{10.2147/COPD.S147065}}, volume = {{12}}, year = {{2017}}, }