Correlation between kidney transplantation and colorectal cancer in hemodialysis patients: A nationwide, retrospective, population-based cohort study

BMC Cancer

Chien-An Sun¹  San-Lin You²  Chi-Feng Hung²  Yong-Chen Chen²  Wen-Chih Wu³  Yu-Feng Tian⁴  Han-En Wang⁵  Wan-Yun Chou⁶  Je-Ming Hu⁷  Yu-Chan Liao⁸  Yu-Ching Chou⁸ 

[1] Big Data Research Center, College of Medicine, Fu-Jen Catholic University;Department of Medicine, College of Medicine, Fu-Jen Catholic University;Department of Surgery, Suao and Yuanshan branches of Taipei Veterans General Hospital;Division of Colorectal Surgery, Department of Surgery;Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center;Graduate Institute of Life Sciences, National Defense Medical Center;Graduate Institute of Medical Sciences, National Defense Medical Center;School of Public Health, National Defense Medical Center;

关键词: Colorectal cancer;    Hemodialysis;    Kidney transplantation;    Retrospective cohort study;   

DOI  :  10.1186/s12885-019-6283-z

来源: DOAJ

【 摘 要 】

Abstract Background Kidney transplantation (KT) correlates with an increased risk of developing several malignancies; however, the risk of colorectal cancer (CRC) after KT remains debatable and has been marginally explored. Hence, in this nationwide, retrospective, population-based cohort study, we aimed to examine the correlation between KT and CRC in a large-scale population-based Chinese cohort. Methods We identified a total of 3739 regular hemodialysis patients undergoing KT (exposed cohort) and 42,324 hemodialysis patients not undergoing KT (non-exposed cohort) between 2000 and 2008 from Taiwan’s National Health Insurance Research Database (NHIRD). Both cohorts were followed up from January 1, 2000, to the date of CRC diagnosis, death, or the end of 2013. Using Kaplan–Meier method, we measured the cumulative incidence of CRC in each cohort. Furthermore, Cox proportional hazards models were used to compute hazards ratios (HRs) and 95% confidence intervals (CIs) to estimate the correlation between KT and CRC in hemodialysis patients. Results The Kaplan–Meier analysis revealed that the cumulative incidence of CRC was significantly higher in the exposed cohort than in the non-exposed cohort (log-rank test, P < 0.001). After adjusting for potential confounders, the exposed cohort exhibited a significantly increased risk of CRC compared with the non-exposed cohort (adjusted HR, 1.34; 95% CI, 1.11–1.62). Conclusions Hemodialysis patients undergoing KT have a significantly higher risk of CRC than those not undergoing KT. Cancer should continue to be a primary focus of prevention during KT.

【 授权许可】

Unknown