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Solid Organ Transplant Patients At Higher Cancer Death Risk

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People who have solid organ transplants are three times more likely to die from cancer than the general population reports a study published Thursday.

The study, found in this month’s JAMA Oncology, focused on the association between cancer risk and organ transplants rather than what the cause of the association may be. Of the over 11,000 patients studied, over 3,000 died, and one in five of those deaths was cancer-related. The patients that were studied were those who, between 1991 and 2010, had liver, kidney, heart, or lung transplants. While patients over 60 were less likely to die from cancer, children had a higher risk of dying.

Transplant recipients are still twice as likely to die from cancer than the general population when the numbers are adjusted to exclude recipients who had pre-transplant malignancies. The average time of death for a post-transplant cancer patient is usually around 5 years after the transplant, suggesting that the immuno-suppressant drugs may play a role.

Despite the fact that SOTRs [solid organ transplant recipients] have shorter life expectancies and a higher risk of dying of non-cancer-related causes, these patients have an elevated risk of cancer death as compared with the general population. Addressing the cancer burden in SOTRs is critical to improving the survival of these patients.

Researchers believe that, in addition to the role the immuno-suppressants play, doctors may not treat cancer as aggressively in people who have had transplants because of the risk of rejection of the transplant.

Skin cancer is particularly concerning for transplant patients, since recipients have a death risk 30 times higher than the general population. This is not only for melanoma, but for both basal- and squamous-cell carcinomas, which are usually easier to treat in the general population.

In addition to the usual advice to reduce cancer risk, such as eating healthy and exercising regularly, transplant recipients must get regular skin checks and do their best to avoid prolonged sun exposure.

Cancer is the second leading cause of death amongst transplant recipients, after heart-related illnesses. The death rate from cardiovascular diseases has been decreasing due to better care from doctors that is more focused on catching and preventing these illnesses.

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