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Risk of cancer after lung transplantation for COPD

Ekström, Magnus LU ; Riise, Gerdt C and Tanash, Hanan A. LU (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.

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author
organization
publishing date
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 Press
external identifiers
  • scopus:85031086073
  • wos:000412397000002
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
2018-01-16 13:25:29
@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&lt;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},
  keyword      = {Cancer,COPD,Lung transplantation,Severe alpha-1-antitrypsin deficiency,Survival},
  language     = {eng},
  month        = {10},
  pages        = {2841--2847},
  publisher    = {Dove Press},
  series       = {International Journal of COPD},
  title        = {Risk of cancer after lung transplantation for COPD},
  url          = {http://dx.doi.org/10.2147/COPD.S147065},
  volume       = {12},
  year         = {2017},
}