MALIGNANCIES AFTER RENAL-TRANSPLANTATION - THE EDTA-ERA REGISTRY EXPERIENCE

The incidence of malignancies in recipients of renal transplants was c ompared to that in non-grafted patients on maintenance dialysis as rep orted to the EDTA-ERA Registry and in the general population as record ed by the cancer registries of England and Wales, of Sweden, of the (f ormer) German Democratic Republic, and of Lombardy and Varese in North ern Italy. For tumours known to be associated with immunosuppression, namely Kaposi's sarcoma, non-Hodgkin lymphoma and the common malignanc ies of the skin (except melanoma), an increased incidence was confirme d for the transplanted population Thyroid carcinoma and hepatoma were found to be more frequent in non-grafted patients on dialysis as well as after renal transplantation. An increased incidence of cancer of th e cervix and of the body of the uterus was recorded only for young coh orts with a functioning graft but not for women after menopause. Most of the other malignancies had similar incidences in grafted and non-gr afted populations which did not differ from those in the general popul ations of the cancer registries except cancer of the colon which was s lightly more frequent, particularly at 10-20 years after the first tra nsplant operation. Survival after diagnosis of cancer at the most freq uent sites, such as bronchopulmonary, breast, oesophagogastric and col orectal cancer, did not differ between non-grafted patient groups on d ialysis and those who developed the tumour while carrying a functionin g renal transplant. Although certain specific malignancies such as non -Hodgkin lymphoma and skin tumours occur more frequently in recipients of renal grafts, the risk of developing cancer has been exaggerated a nd survival after diagnosis of the common cancers does not appear to b e affected to any great extent by immunosuppressive therapy.