Aliza K Fink1, Elizabeth L Yanik2, Bruce C Marshall3, Michael Wilschanski4, Charles F Lynch5, April A Austin6, Glenn Copeland7, Mahboobeh Safaeian2, Eric A Engels2. 1. Cystic Fibrosis Foundation, Bethesda, MD, USA. Electronic address: afink@cff.org. 2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 3. Cystic Fibrosis Foundation, Bethesda, MD, USA. 4. Department of Pediatric Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel. 5. Department of Epidemiology, The University of Iowa, Iowa City, IA, USA. 6. New York State Cancer Registry, New York State Department of Health, Albany, NY, USA. 7. Michigan Cancer Surveillance Program, Michigan Department of Health and Human Services, Lansing, MI, USA.
Abstract
BACKGROUND: Previous studies demonstrated increased digestive tract cancers among individuals with cystic fibrosis (CF), particularly among lung transplant recipients. We describe cancer incidence among CF and non-CF lung recipients. METHODS: We used data from the US transplant registry and 16 cancer registries. Standardized incidence ratios (SIRs) compared cancer incidence to the general population, and competing risk methods were used for the cumulative incidence of colorectal cancer. RESULTS: We evaluated 10,179 lung recipients (1681 with CF). Risk was more strongly increased in CF recipients than non-CF recipients for overall cancer (SIR 9.9 vs. 2.7) and multiple cancers including colorectal cancer (24.2 vs. 1.7), esophageal cancer (56.3 vs. 1.3), and non-Hodgkin lymphoma (61.8 vs. 9.4). At five years post-transplant, colorectal cancer was diagnosed in 0.3% of CF recipients aged <50 at transplant and 6.4% aged ≥50. CONCLUSIONS: CF recipients have increased risk for colorectal cancer, suggesting a need for enhanced screening.
BACKGROUND: Previous studies demonstrated increased digestive tract cancers among individuals with cystic fibrosis (CF), particularly among lung transplant recipients. We describe cancer incidence among CF and non-CF lung recipients. METHODS: We used data from the US transplant registry and 16 cancer registries. Standardized incidence ratios (SIRs) compared cancer incidence to the general population, and competing risk methods were used for the cumulative incidence of colorectal cancer. RESULTS: We evaluated 10,179 lung recipients (1681 with CF). Risk was more strongly increased in CF recipients than non-CF recipients for overall cancer (SIR 9.9 vs. 2.7) and multiple cancers including colorectal cancer (24.2 vs. 1.7), esophageal cancer (56.3 vs. 1.3), and non-Hodgkin lymphoma (61.8 vs. 9.4). At five years post-transplant, colorectal cancer was diagnosed in 0.3% of CF recipients aged <50 at transplant and 6.4% aged ≥50. CONCLUSIONS: CF recipients have increased risk for colorectal cancer, suggesting a need for enhanced screening.
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