CoChat
Sign Up
Cited by 1,524Viral-associated cancers and disordersTransplantation: Methods and OutcomesRenal Transplantation Outcomes and Treatments

The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.

Spectrum of Cancer Risk Among US Solid Organ Transplant Recipients

Open access
Engels, Eric A., Pfeiffer, Ruth M., Fraumeni, Joseph F., Kasiske, Bertram L., Israni, Ajay K., Snyder, Jon J., Wolfe, Robert A., Goodrich, Nathan P., Bayakly, A. Rana, Clarke, Christina A., Copeland, Glenn, Finch, Jack L., Fleissner, Mary Lou, Goodman, Marc T., Kahn, Amy, Koch, Lori, Lynch, Charles F., Madeleine, Margaret M., Pawlish, Karen, Rao, Chandrika, Williams, Melanie A., Castenson, David, Curry, Michael, Parsons, Ruth, Fant, Gregory, Lin, Monica·2011·JAMA
DOI 10.1001/jama.2011.1592PMC PMC3310893
Open this paper in CoChat — free account

Abstract

CONTEXT: Solid organ transplant recipients have elevated cancer risk due to immunosuppression and oncogenic viral infections. Because most prior research has concerned kidney recipients, large studies that include recipients of differing organs can inform cancer etiology. OBJECTIVE: To describe the overall pattern of cancer following solid organ transplantation. DESIGN, SETTING, AND PARTICIPANTS: Cohort study using linked data on solid organ transplant recipients from the US Scientific Registry of Transplant Recipients (1987-2008) and 13 state and regional cancer registries. MAIN OUTCOME MEASURES: Standardized incidence ratios (SIRs) and excess absolute risks (EARs) assessing relative and absolute cancer risk in transplant recipients compared with the general population. RESULTS: The registry linkages yielded data on 175,732 solid organ transplants (58.4% for kidney, 21.6% for liver, 10.0% for heart, and 4.0% for lung). The overall cancer risk was elevated with 10,656 cases and an incidence of 1375 per 100,000 person-years (SIR, 2.10 [95% CI, 2.06-2.14]; EAR, 719.3 [95% CI, 693.3-745.6] per 100,000 person-years). Risk was increased for 32 different malignancies, some related to known infections (eg, anal cancer, Kaposi sarcoma) and others unrelated (eg, melanoma, thyroid and lip cancers). The most common malignancies with elevated risk were non-Hodgkin lymphoma (n = 1504; incidence: 194.0 per 100,000 person-years; SIR, 7.54 [95% CI, 7.17-7.93]; EAR, 168.3 [95% CI, 158.6-178.4] per 100,000 person-years) and cancers of the lung (n = 1344; incidence: 173.4 per 100,000 person-years; SIR, 1.97 [95% CI, 1.86-2.08]; EAR, 85.3 [95% CI, 76.2-94.8] per 100,000 person-years), liver (n = 930; incidence: 120.0 per 100,000 person-years; SIR, 11.56 [95% CI, 10.83-12.33]; EAR, 109.6 [95% CI, 102.0-117.6] per 100,000 person-years), and kidney (n = 752; incidence: 97.0 per 100,000 person-years; SIR, 4.65 [95% CI, 4.32-4.99]; EAR, 76.1 [95% CI, 69.3-83.3] per 100,000 person-years). Lung cancer risk was most elevated in lung recipients (SIR, 6.13 [95% CI, 5.18-7.21]) but also increased among other recipients (kidney: SIR, 1.46 [95% CI, 1.34-1.59]; liver: SIR, 1.95 [95% CI, 1.74-2.19]; and heart: SIR, 2.67 [95% CI, 2.40-2.95]). Liver cancer risk was elevated only among liver recipients (SIR, 43.83 [95% CI, 40.90-46.91]), who manifested exceptional risk in the first 6 months (SIR, 508.97 [95% CI, 474.16-545.66]) and a 2-fold excess risk for 10 to 15 years thereafter (SIR, 2.22 [95% CI, 1.57-3.04]). Among kidney recipients, kidney cancer risk was elevated (SIR, 6.66 [95% CI, 6.12-7.23]) and bimodal in onset time. Kidney cancer risk also was increased in liver recipients (SIR, 1.80 [95% CI, 1.40-2.29]) and heart recipients (SIR, 2.90 [95% CI, 2.32-3.59]). CONCLUSION: Compared with the general population, recipients of a kidney, liver, heart, or lung transplant have an increased risk for diverse infection-related and unrelated cancers.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jama.2011.1592

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Show all 43 references

Cited by

Sorted by citations

Items 701–800 of 1,000

Related

See all

Metadata

Authors
Engels, E. A., Pfeiffer, R. M., Fraumeni, J. F., Kasiske, B. L., Israni, A. K., Snyder, J. J., Wolfe, R. A., Goodrich, N. P., Bayakly, A. R., Clarke, C. A., Copeland, G., Finch, J. L., Fleissner, M. L., Goodman, M. T., Kahn, A., Koch, L., Lynch, C. F., Madeleine, M. M., Pawlish, K., Rao, C., Williams, M. A., Castenson, D., Curry, M., Parsons, R., Fant, G., & Lin, M.
Affiliations
  • National Institutes of Health (US)
  • Arbor Research Collaborative for Health (US)
  • Cancer Prevention Institute of California (US)
  • Michigan Department of Health and Human Services (US)
  • Connecticut Agricultural Experiment Station (US)
  • University of Hawaiʻi at Mānoa (US)
  • Illinois Department of Public Health (US)
  • University of Iowa (US)
  • Fred Hutch Cancer Center (US)
  • New Jersey Department of Health (US)
  • Texas Department of State Health Services (US)
  • Information Management Services (US)
  • United States Department of Health and Human Services (US)
Corresponding author
Engels, Eric A.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2011-11-02
Volume
306
Issue
17
Pages
1891
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2011.1592
PMC
PMC3310893
OpenAlex
W1964106115
Cited by
1,524
References
43
Citations by year
2026: 83 · 2025: 100 · 2024: 100 · 2023: 89 · 2022: 106 · 2021: 114 · 2020: 134 · 2019: 124 · 2018: 107 · 2017: 114 · 2016: 108 · 2015: 106 · 2014: 97 · 2013: 83 · 2012: 55
FWCI
37.37
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01pc54405-9-0-0, n01pc35143-20-0-1, n01pc35139-25-0-11, n01pc35142-19-0-0, n01pc35137-18-0-2)
  • National Cancer Institute (N01PC35139, HHSN261201000034 C, HHSN261201000036C, HHSN261201000035C, N01‐PC035137, N01 PC035143, N01 PC35142, HHSN261201000037C, N01-PC-54405, HHSN261201000035I, N01-PC-35 137, N01PC-35143, N01 PC035139, HHSN261201000024C, N01 PC035142, N01 PC054405, ZIACP010150)
  • National Center for Chronic Disease Prevention and Health Promotion (5U58DP000824-04, 5U58DP000812-03, U58 DP000812, U58 DP000817, U58 DP000805, U58 DP000807, U58 DP000848-04, U58 DP000832, 5U58DP000817-05, U58 DP000824, U58/DP000808, #1U58DP000807-01, 5658DP 000805-04, U58 DP000848, 5U58/DP000808-03)
Topics
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
Keywords
solid organ transplant recipients, cancer risk, immunosuppression, non-Hodgkin lymphoma, lung cancer, Kaposi's sarcoma, anal cancer, melanoma, thyroid cancer, lip cancer, hepatitis C, cytomegalovirus, Epstein-Barr virus, post-transplant lymphoproliferative disorder
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Immune Tolerance, Infant, Male, Middle Aged, Neoplasms, Registries, Risk, United States, Cohort Studies, Incidence, Organ Transplantation, Immunocompromised Host, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review