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American Journal of Epidemiology Vol. 126, No. 3: 370-376
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

CANCER IN PATIENTS RECEIVING LONG-TERM DIALYSIS TREATMENT

ARLENE F. KANTOR1,, ROBERT N. HOOVER1, LEO J. KINLEN2, MICHAEL R. McMULLAN3 and JOSEPH F. FRAUMENI, JR.1

1Environmental Epidemiology Branch, National Cancer Institute Bethesda, MD
2Radcliffe Infirmary, Oxford University Oxford OX 2 6HE, England. Previous affiliation: Visiting Scientist, Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD
3Health Care Financing Administration Baltimore, MD

Reprint requests to Dr. Arlene F. Kantor, NCI Field Station, Dana-Farber Cancer Institute, Dana 1110,44 Binney Street, Boston, MA 02115

Kantor, A. F. (Environmental Epidemiology Branch, NCl, Bethesda, MD 20892), R. N. Hoover, L. J. Kinlen, M. R. McMullan, and J. F. Fraumeni, Jr. Cancer in patients receiving long-term dialysis treatment. Am J Epidemiol 1987;126:370-6.

A large excess of non-Hodgkin's lymphoma has been documented in renal transplant patients and may be related to immunosuppressive therapy, persistent antigenic challenge from the graft, or both. To determine whether immuno suppression resulting from chronic renal failure is associated with an elevated risk of certain tumors such as non-Hodgkin's lymphoma, the authors studied cancer incidence in a national cohort of 28,049 patients in the United States with chronic renal failure who received maintenance dialysis for at least six months (totaling 66,706 person-years of observation). Compared with national incidence rates, the relative risk (RR) of cancer was 0.9 (excluding nonmelanoma skin cancer, multiple myeloma, kidney cancer, and uterine cervix cancer). Moderate excesses of leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, thyroid cancer, and biliary tract cancer were found, but were not statistically significant for both sexes combined. A significantly elevated risk of non-Hodgkin's lymphoma among patients with chronic glomerulonephritis (RR = 2.6) accounted for the excess observed in the total series, raising the possibility of factors specific to this disease.

dialysis; glomerulonephritis; immunosuppression; kidney failure; chronic; lymphoma; neoplasms


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