Increased cancer risk in patients undergoing dialysis: a population-based cohort study in North-Eastern Italy.
Cancer risk
Dialysis
End-stage kidney disease
Italy
Population-based study
de novo malignancies
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
28 03 2019
28 03 2019
Historique:
received:
28
11
2018
accepted:
07
03
2019
entrez:
30
3
2019
pubmed:
30
3
2019
medline:
7
3
2020
Statut:
epublish
Résumé
In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy. A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998-2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15-1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42-2.45 for age 40-59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89-10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06-4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46-2.22), oral cavity (SIR = 2.42, 95% CI: 1.36-4.00), and Kaposi's sarcoma (SIR = 10.29, 95% CI: 1.25-37.16). The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.
Sections du résumé
BACKGROUND
In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy.
METHODS
A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998-2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs).
RESULTS
During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15-1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42-2.45 for age 40-59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89-10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06-4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46-2.22), oral cavity (SIR = 2.42, 95% CI: 1.36-4.00), and Kaposi's sarcoma (SIR = 10.29, 95% CI: 1.25-37.16).
CONCLUSIONS
The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.
Identifiants
pubmed: 30922296
doi: 10.1186/s12882-019-1283-4
pii: 10.1186/s12882-019-1283-4
pmc: PMC6437907
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
107Investigateurs
Sarah Shalaby
(S)
Raffaella Petrara
(R)
Patrizia Burra
(P)
Giacomo Zanus
(G)
Stefano Zanini
(S)
Paolo Rigotti
(P)
Maria Rendina
(M)
Alfredo Di Leo
(A)
Francesco Paolo Schena
(FP)
Giuseppe Grandaliano
(G)
Marco Fiorentino
(M)
Augusto Lauro
(A)
Antonio Daniele Pinna
(AD)
Paolo Di Gioia
(P)
Sara Pellegrini
(S)
Chiara Zanfi
(C)
Maria Piera Scolari
(MP)
Sergio Stefoni
(S)
Paola Todeschini
(P)
Laura Panicali
(L)
Chiara Valentini
(C)
Umberto Baccarani
(U)
Andrea Risaliti
(A)
Gian Luigi Adani
(GL)
Dario Lorenzin
(D)
Giuseppe Maria Ettorre
(GM)
Giovanni Vennarecci
(G)
Marco Colasanti
(M)
Manuela Coco
(M)
Fabrizio Ettorre
(F)
Roberto Santoro
(R)
Lucia Miglioresi
(L)
Francesco Nudo
(F)
Massimo Rossi
(M)
Gianluca Mennini
(G)
Luca Toti
(L)
Giuseppe Tisone
(G)
Annachiara Casella
(A)
Laura Fazzolari
(L)
Daniele Sforza
(D)
Giuseppe Iaria
(G)
Carlo Gazia
(C)
Chiara Belardi
(C)
Claudia Cimaglia
(C)
Alessandro Agresta
(A)
Gianpiero D'Offizi
(G)
Ubaldo Visco Comandini
(UV)
Raffaella Lionetti
(R)
Marzia Montalbano
(M)
Chiara Taibi
(C)
Giovanni Fantola
(G)
Fausto Zamboni
(F)
Gian Benedetto Piredda
(GB)
Maria Benigna Michittu
(MB)
Maria Gavina Murgia
(MG)
Bruno Onano
(B)
Lucia Fratino
(L)
Luigino Dal Maso
(LD)
Paolo De Paoli
(P)
Diana Verdirosi
(D)
Emanuela Vaccher
(E)
Francesco Pisani
(F)
Antonio Famulari
(A)
Federica Delreno
(F)
Samuele Iesari
(S)
Linda De Luca
(L)
Maurizio Iaria
(M)
Enzo Capocasale
(E)
Elena Cremaschi
(E)
Silvio Sandrini
(S)
Francesca Valerio
(F)
Valentina Mazzucotelli
(V)
Nicola Bossini
(N)
Gisella Setti
(G)
Massimiliano Veroux
(M)
Pierfrancesco Veroux
(P)
Alessia Giaquinta
(A)
Domenico Zerbo
(D)
Ghil Busnach
(G)
Laura Di Leo
(L)
Maria Luisa Perrino
(ML)
Marialuisa Querques
(M)
Valeriana Colombo
(V)
Maria Chiara Sghirlanzoni
(MC)
Piergiorgio Messa
(P)
Antonio Leoni
(A)
Laura Galatioto
(L)
Salvatore Gruttadauria
(S)
Vito Sparacino
(V)
Flavia Caputo
(F)
Barbara Buscemi
(B)
Franco Citterio
(F)
Gionata Spagnoletti
(G)
Maria Paola Salerno
(MP)
Evaldo Favi
(E)
Giuseppe Paolo Segoloni
(GP)
Luigi Biancone
(L)
Antonio Lavacca
(A)
Maria Cristina Maresca
(MC)
Carmelo Cascone
(C)
Bice Virgilio
(B)
Donato Donati
(D)
Fiorella Dossi
(F)
Andrea Fontanella
(A)
Andrea Ambrosini
(A)
Marco Di Cicco
(M)
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