CANCER AMONG PATIENTS ON RENAL REPLACEMENT THERAPY - A POPULATION-BASED SURVEY IN LOMBARDY, ITALY

Longer and better survival of End-Stage Renal Disease (ESRD) patients undergoing renal replacement therapy (RRT) is now associated with a hi gher prevalence of new elderly patients receiving renal replacement th erapy (dialysis). In order to help clarify the association of cancer r isk with RRT, the incidence of cancer in a population-based cohort of uraemic patients in the Region of Lombardy, northern Italy, was undert aken using data from the Lombardy Regional Dialysis and Renal Transpla nt Registry. A total of 479 cases of cancer of all sites was recorded in this population. There were statistically significantly elevated ri sks of primary liver cancer, kidney cancer, thyroid cancer, lymphoma a nd multiple myeloma. When the data were examined according to primary renal diseases, there did not appear to be any particular association between excess cancer risk and the underlying pathology. While some ca ution must be expressed in interpreting these data, due to the relativ ely small numbers of cases expected in many of the disease entities, t he results indicate an excess of renal-cell and liver carcinomas and l ymphomas in patients receiving RRT and highlight the necessity of care ful follow-up and awareness of these associations, together with the n eed for early detection of such tumours. (C) 1996 Wiley-Liss, Inc.