Elevated Risk for Lung CA in Lung Transplant Recipients Explored

Recipients of a lung transplant, especially a single lung transplant, have an elevated risk for lung cancer, particularly in the native lung, according to a study published online Dec. 18 in the American Journal of Transplantation.

Matthew Triplette, M.D., M.P.H., from the University of Washington in Seattle, and colleagues examined the incidence of lung cancer among lung transplant recipients using matched transplant and cancer registry data from 17 U.S. states/regions during 1987 to 2012.

The researchers found an increased risk for lung cancer among lung recipients (standardized incidence ratio, 4.8 compared with the general population). Risk was increased 13-fold in the native lung for those with a single lung transplant. Risk factors for native lung cancer included age, prior smoking, time since transplant, and idiopathic pulmonary fibrosis. Lung cancers in transplant recipients were more frequently a localized stage and treated surgically (P = 0.02 and 0.05, respectively) compared with cases in the general population. Higher all-cause and cancer-specific mortality was seen for lung recipients (adjusted hazard ratios, 1.9 and 1.67, respectively).

"While our findings point to an additional influence of posttransplant factors on lung cancer risk, the unique contribution of specific factors such as immunosuppressants, and role of posttransplant infections on risk of lung cancer will require future examination," the authors write.

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